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Movahed F, Heidari E, Sadeghi D, Rezaei Nejad A, Abyaneh R, Zarei M, Beigi F, Abdollahi A, Shafiee A. Incident diabetes in adolescents using antidepressant: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02502-x. [PMID: 38914830 DOI: 10.1007/s00787-024-02502-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 06/17/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND The use of antidepressants has been on the rise among adolescents and young adults, populations also increasingly at risk for type 2 diabetes. However, the relationship between antidepressant uses and diabetes incidence in these age groups remains poorly understood. METHODS Adhering to PRISMA guidelines and the Cochrane Handbook, we conducted a comprehensive search in PubMed, Scopus, Embase, and Web of Science up to 21 February 2024, registering our protocol on PROSPERO (CRD42024516272). RESULTS Six studies, ranging from 16, 470 to 1, 582, 914 participants and spanning 2010 to 2023 across North America, Europe, and Asia, were included. The meta-analysis revealed a significant association between antidepressant use and diabetes onset, with 10 cases per 1, 000 observations (p < 0.01; I2 = 100%). Adolescents using high doses of antidepressants showed a 62% increased risk of developing diabetes compared to non-users or those on low doses (Risk ratio = 1.67; 95% CI 1.19-2.35; I2 = 87%; p < 0.01). The overall quality of the studies was high, with an average Newcastle-Ottawa Scale score of 7.66. Sensitivity analysis highlighted the robustness of these findings, except when removing specific studies, indicating potential sources of heterogeneity. CONCLUSION Antidepressant use in adolescents is associated with a significantly increased risk of diabetes onset, particularly at higher doses. This finding underscores the necessity for vigilant monitoring of glucose levels in this population and warrants further investigation into the underlying mechanisms and long-term outcomes.
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Affiliation(s)
| | - Ehsan Heidari
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Dina Sadeghi
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Qom, Iran
| | | | - Romina Abyaneh
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mehrshad Zarei
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Qom, Iran
| | - Farzan Beigi
- Student Research Committee, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Abolfazl Abdollahi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Arman Shafiee
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
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Klaudia T, Naila H, Zekun L, Gavin B, Min Z, Hannah R, Jessica S, Bo L, Persaud SJ. The selective serotonin reuptake inhibitors, sertraline and paroxetine, improve islet beta-cell mass and function in vitro. Diabetes Obes Metab 2024. [PMID: 38888050 DOI: 10.1111/dom.15701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/16/2024] [Accepted: 05/24/2024] [Indexed: 06/20/2024]
Abstract
AIMS To investigate the effects of the selective serotonin reuptake inhibitors (SSRIs) sertraline and paroxetine at therapeutically relevant concentrations on beta-cell mass and function. METHODS Viability was quantified in mouse insulinoma (MIN6) beta cells and mouse islets after 48-h exposure to sertraline (1-10 μM) or paroxetine (0.01-1 μM) using the Trypan blue exclusion test. The effects of therapeutic concentrations of these SSRIs on insulin secretion were determined by static incubation and perifusion experiments, while islet apoptosis was investigated by Caspase-Glo 3/7 assay, TUNEL staining and quantitative PCR analysis. Finally, proliferation of MIN6 and mouse islet beta cells was assessed by bromodeoxyuridine (BrdU) enzyme-linked immunosorbent assay and immunofluorescence. RESULTS Sertraline (0.1-1 μM) and paroxetine (0.01-0.1 μM) were well tolerated by MIN6 beta cells and islets, whereas 10 μM sertraline and 1 μM paroxetine were cytotoxic. Exposure to 1 μM sertraline and 0.1 μM paroxetine significantly potentiated glucose-stimulated insulin secretion from mouse and human islets. Moreover, they showed protective effects against cytokine- and palmitate-induced apoptosis of islets, they downregulated cytokine-induced Stat1 and Traf1 mRNA expression, and they significantly increased proliferation of mouse beta cells. CONCLUSIONS Our data demonstrate that sertraline and paroxetine act directly on beta cells to enhance glucose-stimulated insulin secretion and stimulate beta-cell mass expansion by increasing proliferation and decreasing apoptosis. These drugs are therefore likely to be appropriate for treating depression in people with type 2 diabetes.
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Affiliation(s)
- Toczyska Klaudia
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Haq Naila
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Lyu Zekun
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Bewick Gavin
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Zhao Min
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Rosa Hannah
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Starikova Jessica
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Liu Bo
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Shanta Jean Persaud
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
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Kim J, Hurh K, Han S, Kim H, Park EC, Jang SY. Association between antidepressants and the risk of diabetic foot ulcers and amputation in antidepressant-naïve type 2 diabetes mellitus patients: A nested case-control study. Diabetes Res Clin Pract 2024; 209:111591. [PMID: 38403177 DOI: 10.1016/j.diabres.2024.111591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/15/2023] [Accepted: 02/22/2024] [Indexed: 02/27/2024]
Abstract
AIMS Antidepressants are widely used by individuals with type 2 diabetes mellitus (T2DM). This study aimed to explore the correlation between antidepressant use, considering specific antidepressant subclasses or cumulative doses, and diabetic foot ulcer (DFU) risk. METHODS This nested case-control study was conducted using a representative population-based Korean cohort database from 2002 to 2019. Participants with DFUs were matched with participants without DFUs based on age, sex, date of T2DM diagnosis, and follow-up duration. In total, 791 DFUs and 3900 controls were included. The association between antidepressant use or cumulative dose of each antidepressant subclass, DFU risk and amputation risk was examined using a conditional logistic regression model. RESULTS Antidepressant ever-use was associated with an increased incidence of DFUs compared with non-use. Furthermore, an increase in DFU risk was evident with increasing cumulative antidepressant dosage, particularly among tricyclic antidepressant (TCA) ever-users and selective serotonin reuptake inhibitors (SSRIs) ever-users. Additionally, antidepressant ever-users displayed a higher risk of DFUs requiring amputation, which was consistently observed when the cumulative dosages of overall antidepressants and TCAs were considered. CONCLUSION Caution is advised when administering TCAs and SSRIs in antidepressant-naïve T2DM patients to reduce DFU and the consequent amputation risk.
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Affiliation(s)
- Jinhyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyungduk Hurh
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Seokmoon Han
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyunkyu Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Suk-Yong Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
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Hu M, Cai JY, He Y, Chen K, Hao F, Kang JS, Pan Y, Tie L, Li XJ. Protective effects of curcumin on desipramine-induced islet β-cell damage via AKAP150/PKA/PP2B complex. Acta Pharmacol Sin 2024; 45:327-338. [PMID: 37845344 PMCID: PMC10789796 DOI: 10.1038/s41401-023-01176-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 09/23/2023] [Indexed: 10/18/2023] Open
Abstract
Tricyclic antidepressants (TCAs) are widely used to treat depression and anxiety-related mood disorders. But evidence shows that TCAs elevate blood glucose levels and inhibit insulin secretion, suggesting that TCAs are a risk factor, particularly for individuals with diabetes. Curcumin is a bioactive molecule from the rhizome of the Curcuma longa plant, which has shown both antidepressant and anti-diabetic activities. In the present study, we investigated the protective effect of curcumin against desipramine-induced apoptosis in β cells and the underlying molecular mechanisms. In the mouse forced swimming test (FST), we found that lower doses of desipramine (5 and 10 mg/kg) or curcumin (2.5 mg/kg) alone did not affect the immobility time, whereas combined treatment with curcumin (2.5 mg/kg) and desipramine (5, 10 mg/kg) significantly decreased the immobility time. Furthermore, desipramine dose-dependently inhibited insulin secretion and elevated blood glucose levels, whereas the combined treatment normalized insulin secretion and blood glucose levels. In RIN-m5F pancreatic β-cells, desipramine (10 μM) significantly reduced the cell viability, whereas desipramine combined with curcumin dose-dependently prevented the desipramine-induced impairment in glucose-induced insulin release, most effectively with curcumin (1 and 10 μM). We demonstrated that desipramine treatment promoted the cleavage and activation of Caspase 3 in RIN-m5F cells. Curcumin treatment inhibited desipramine-induced apoptosis, increased mitochondrial membrane potential and Bcl-2/Bax ratio. Desipramine increased the generation of reactive oxygen species, which was reversed by curcumin treatment. Curcumin also inhibited the translocation of forkhead box protein O1 (FOXO1) from the cytoplasm to the nucleus and suppressed the binding of A-kinase anchor protein 150 (AKAP150) to protein phosphatase 2B (PP2B, known as calcineurin) that was induced by desipramine. These results suggest that curcumin protects RIN-m5F pancreatic β-cells against desipramine-induced apoptosis by inhibiting the phosphoinositide 3-kinase/AKT/FOXO1 pathway and the AKAP150/PKA/PP2B interaction. This study suggests that curcumin may have therapeutic potential as an adjunct to antidepressant treatment.
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Affiliation(s)
- Min Hu
- Department of Pharmacology, School of Basic Medical Sciences, Peking University & Beijing Key Laboratory of Tumor Systems Biology, Peking University, Beijing, 100191, China
| | - Jia-Ying Cai
- Department of Pharmacology, School of Basic Medical Sciences, Peking University & Beijing Key Laboratory of Tumor Systems Biology, Peking University, Beijing, 100191, China
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Yao He
- Department of Pharmacology, School of Basic Medical Sciences, Peking University & Beijing Key Laboratory of Tumor Systems Biology, Peking University, Beijing, 100191, China
| | - Kui Chen
- Department of Pharmacology, School of Basic Medical Sciences, Peking University & Beijing Key Laboratory of Tumor Systems Biology, Peking University, Beijing, 100191, China
| | - Feng Hao
- Department of Pharmacology, School of Basic Medical Sciences, Peking University & Beijing Key Laboratory of Tumor Systems Biology, Peking University, Beijing, 100191, China
| | - Jin-Sen Kang
- Department of Pharmacology, School of Basic Medical Sciences, Peking University & Beijing Key Laboratory of Tumor Systems Biology, Peking University, Beijing, 100191, China
| | - Yan Pan
- Department of Pharmacology, School of Basic Medical Sciences, Peking University & Beijing Key Laboratory of Tumor Systems Biology, Peking University, Beijing, 100191, China
| | - Lu Tie
- Department of Pharmacology, School of Basic Medical Sciences, Peking University & Beijing Key Laboratory of Tumor Systems Biology, Peking University, Beijing, 100191, China.
| | - Xue-Jun Li
- Department of Pharmacology, School of Basic Medical Sciences, Peking University & Beijing Key Laboratory of Tumor Systems Biology, Peking University, Beijing, 100191, China.
- Department of Pharmacology, School of Pharmacy, Shihezi University, Shihezi, 832002, China.
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Roberts FL, Cataldo LR, Fex M. Monoamines' role in islet cell function and type 2 diabetes risk. Trends Mol Med 2023; 29:1045-1058. [PMID: 37722934 DOI: 10.1016/j.molmed.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/20/2023]
Abstract
The two monoamines serotonin and melatonin have recently been highlighted as potent regulators of islet hormone secretion and overall glucose homeostasis in the body. In fact, dysregulated signaling of both amines are implicated in β-cell dysfunction and development of type 2 diabetes mellitus (T2DM). Serotonin is a key player in β-cell physiology and plays a role in expansion of β-cell mass. Melatonin regulates circadian rhythm and nutrient metabolism and reduces insulin release in human and rodent islets in vitro. Herein, we focus on the role of serotonin and melatonin in islet physiology and the pathophysiology of T2DM. This includes effects on hormone secretion, receptor expression, genetic variants influencing β-cell function, melatonin treatment, and compounds that alter serotonin availability and signaling.
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Affiliation(s)
- Fiona Louise Roberts
- Lund University Diabetes Centre, Department of Clinical Sciences, Unit for Molecular Metabolism, SE-21428 Malmö, Sweden
| | - Luis Rodrigo Cataldo
- Lund University Diabetes Centre, Department of Clinical Sciences, Unit for Molecular Metabolism, SE-21428 Malmö, Sweden; The Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DK-2200, Denmark
| | - Malin Fex
- Lund University Diabetes Centre, Department of Clinical Sciences, Unit for Molecular Metabolism, SE-21428 Malmö, Sweden.
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Maina JG, Balkhiyarova Z, Nouwen A, Pupko I, Ulrich A, Boissel M, Bonnefond A, Froguel P, Khamis A, Prokopenko I, Kaakinen M. Bidirectional Mendelian Randomization and Multiphenotype GWAS Show Causality and Shared Pathophysiology Between Depression and Type 2 Diabetes. Diabetes Care 2023; 46:1707-1714. [PMID: 37494602 PMCID: PMC10465984 DOI: 10.2337/dc22-2373] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/21/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Depression is a common comorbidity of type 2 diabetes. We assessed the causal relationships and shared genetics between them. RESEARCH DESIGN AND METHODS We applied two-sample, bidirectional Mendelian randomization (MR) to assess causality between type 2 diabetes and depression. We investigated potential mediation using two-step MR. To identify shared genetics, we performed 1) genome-wide association studies (GWAS) separately and 2) multiphenotype GWAS (MP-GWAS) of type 2 diabetes (19,344 case subjects, 463,641 control subjects) and depression using major depressive disorder (MDD) (5,262 case subjects, 86,275 control subjects) and self-reported depressive symptoms (n = 153,079) in the UK Biobank. We analyzed expression quantitative trait locus (eQTL) data from public databases to identify target genes in relevant tissues. RESULTS MR demonstrated a significant causal effect of depression on type 2 diabetes (odds ratio 1.26 [95% CI 1.11-1.44], P = 5.46 × 10-4) but not in the reverse direction. Mediation analysis indicated that 36.5% (12.4-57.6%, P = 0.0499) of the effect from depression on type 2 diabetes was mediated by BMI. GWAS of type 2 diabetes and depressive symptoms did not identify shared loci. MP-GWAS identified seven shared loci mapped to TCF7L2, CDKAL1, IGF2BP2, SPRY2, CCND2-AS1, IRS1, CDKN2B-AS1. MDD has not brought any significant association in either GWAS or MP-GWAS. Most MP-GWAS loci had an eQTL, including single nucleotide polymorphisms implicating the cell cycle gene CCND2 in pancreatic islets and brain and the insulin signaling gene IRS1 in adipose tissue, suggesting a multitissue and pleiotropic underlying mechanism. CONCLUSIONS Our results highlight the importance to prevent type 2 diabetes at the onset of depressive symptoms and the need to maintain a healthy weight in the context of its effect on depression and type 2 diabetes comorbidity.
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Affiliation(s)
- Jared G. Maina
- INSERM UMR 1283, CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, Lille, France
- University of Lille, Lille University Hospital, Lille, France
| | - Zhanna Balkhiyarova
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, U.K
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K
- People-Centred Artificial Intelligence Institute, University of Surrey, Guildford, U.K
| | - Arie Nouwen
- Department of Psychology, Middlesex University, London, U.K
| | - Igor Pupko
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, U.K
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K
| | - Anna Ulrich
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K
| | - Mathilde Boissel
- INSERM UMR 1283, CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, Lille, France
- University of Lille, Lille University Hospital, Lille, France
| | - Amélie Bonnefond
- INSERM UMR 1283, CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, Lille, France
- University of Lille, Lille University Hospital, Lille, France
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K
| | - Philippe Froguel
- INSERM UMR 1283, CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, Lille, France
- University of Lille, Lille University Hospital, Lille, France
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K
| | - Amna Khamis
- INSERM UMR 1283, CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, Lille, France
- University of Lille, Lille University Hospital, Lille, France
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K
| | - Inga Prokopenko
- INSERM UMR 1283, CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, Lille, France
- University of Lille, Lille University Hospital, Lille, France
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, U.K
- People-Centred Artificial Intelligence Institute, University of Surrey, Guildford, U.K
| | - Marika Kaakinen
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, U.K
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K
- People-Centred Artificial Intelligence Institute, University of Surrey, Guildford, U.K
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Ma Q, Wang L, Liu XX, An ZG, Luo X, Zhang LL, Yan P, Jin L, Cai R, Yi QZ. GLP-1 plays a protective role in hippocampal neuronal cells by activating cAMP-CREB-BDNF signaling pathway against CORT+HG-induced toxicity. Heliyon 2023; 9:e18491. [PMID: 37576283 PMCID: PMC10412908 DOI: 10.1016/j.heliyon.2023.e18491] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/15/2023] Open
Abstract
Major depressive disorder (MDD) with diabetes mellitus (DM) significantly reduces the quality of the patient's life, and currently, there is no effective treatment. This study explored the feasibility of Glucagon-like peptide-1 (GLP-1) in treating MDD combined with DM. The protective effects of GLP-1 on mouse hippocampal neuronal cell line HT22 cultured with corticosterone (CORT) and high glucose (HG) were assessed. HT22 cells were cultured with CORT + HG to construct a cell model of MDD combined with DM. Cell viability and cell apoptosis/necrocytosis were detected by CCK-8 assay and flow cytometry/confocal laser scanning microscopy, respectively, after treatment with GLP-1. In addition, BDNF and neurotransmitter levels, lactic dehydrogenase (LDH) and glucose levels, and proteins of cAMP-CREB-BDNF signal pathway in the culture supernatants were measured through an enzyme-linked immunosorbent assay and colorimetric assays and Western blot, respectively. The ideal intervention combination to construct a cell model of MDD combined with DM was CORT 200 μM and HG 50 mM for 48 h. After treatment of 50 nM GLP-1 for 48 h, the model+50 nM GLP-1 group's apoptosis and necrocytosis rates and LDH and glucose concentrations in the culture supernatants decreased significantly compared with the model group. However, the BDNF, 5-hydroxytryptamine (5-HT), dopamine (DA), norepinephrine (NE), PKA, p-CREB, and p-Trkb concentrations in the culture supernatants increased significantly. GLP-1 functioned against CORT + HG-induced toxicity by activating the cAMP-CREB-BDNF signaling pathway in hippocampal neuronal cells.
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Affiliation(s)
- Qi Ma
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
| | - Li Wang
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
| | - Xiang-Xin Liu
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, China
- Department of Psychological Medicine, First People's Hospital of Kashi Region, Kashi, 844000, China
| | - Zhi-Guo An
- Psychological Medicine Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
| | - Xiao Luo
- Psychological Medicine Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
| | - Li-Li Zhang
- Psychological Medicine Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
| | - Ping Yan
- Psychological Medicine Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
| | - Lu Jin
- Psychological Medicine Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
| | - Ren Cai
- Specimen Bank of Xinjiang Key Diseases, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
| | - Qi-Zhong Yi
- Psychological Medicine Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
- Xinjiang Clinical Research Center for Mental Health, Urumqi, 830054, China
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Santi NS, Biswal SB, Naik BN, Sahoo JP, Rath B. Metabolic Effects of Antidepressants: Results of a Randomized Study's Interim Analysis. Cureus 2023; 15:e42585. [PMID: 37641760 PMCID: PMC10460471 DOI: 10.7759/cureus.42585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Individuals with major depressive disorder exhibit a dysregulated metabolic profile. There are few studies on how vilazodone, escitalopram, and vortioxetine alter metabolic parameters. Our study aimed to determine the change in plasma glucose, HbA1c, serum cholesterol, triglyceride, and creatinine at 12 weeks. METHODS An ongoing randomized, open-label, three-arm study's interim analysis is portrayed here. The participants were assessed at baseline, 4, 8, and 12 weeks after receiving oral tablets of either vilazodone (20-40mg/d), escitalopram (10-20mg/d), or vortioxetine (5-20mg/d). This study is CTRI-registered (2022/07/043808). RESULTS Of 71 recruited participants, 49 (69%) completed the 12-week visit. The median Hamilton Depression Rating Scale (HDRS) scores of the participants in vilazodone, escitalopram, and vortioxetine groups were 30.0, 29.5, and 29.0 at baseline (p=0.76) and 19.5, 19.5, and 18.0 (p=0.18) at 12 weeks, respectively. The median fasting blood sugar (FBS) values were 98.5, 105.5, and 98.0 at baseline (p=0.07) and 94.0, 99.5, and 96.0 (p=0.19) at 12 weeks, for vilazodone, escitalopram, and vortioxetine groups, respectively. The post hoc analysis did not yield statistically significant differences regarding any parameters. CONCLUSION According to this interim study, the HDRS scores declined after 12 weeks of therapy. The subjects' metabolic parameters did not significantly change. It is essential to perform further investigation regarding these impacts.
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Affiliation(s)
- N Simple Santi
- Pharmacology, Veer Surendra Sai Institute of Medical Sciences and Research, Sambalpur, IND
| | - Sashi B Biswal
- Pharmacology, Veer Surendra Sai Institute of Medical Sciences and Research, Sambalpur, IND
| | - Birendra Narayan Naik
- Psychiatry, Veer Surendra Sai Institute of Medical Sciences and Research, Sambalpur, IND
| | | | - Bhabagrahi Rath
- Pharmacology, Veer Surendra Sai Institute of Medical Sciences and Research, Sambalpur, IND
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9
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Robinson DJ, Hanson K, Jain AB, Kichler JC, Mehta G, Melamed OC, Vallis M, Bajaj HS, Barnes T, Gilbert J, Honshorst K, Houlden R, Kim J, Lewis J, MacDonald B, MacKay D, Mansell K, Rabi D, Sherifali D, Senior P. Diabetes and Mental Health. Can J Diabetes 2023; 47:308-344. [PMID: 37321702 DOI: 10.1016/j.jcjd.2023.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
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10
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Safari M, Asadi A, Aryaeian N, Huseini HF, Shidfar F, Jazayeri S, Malek M, Hosseini AF, Hamidi Z. The effects of melissa officinalis on depression and anxiety in type 2 diabetes patients with depression: a randomized double-blinded placebo-controlled clinical trial. BMC Complement Med Ther 2023; 23:140. [PMID: 37131158 PMCID: PMC10152712 DOI: 10.1186/s12906-023-03978-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/26/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Depression is more common in diabetic patients, with a 1.5-fold increased risk of death.Melissa officinalis (M. officinalis) have anti-diabetic and anti-depression activities. The study aimed to determine the efficacy of M. officinalis extract on depression, anxiety, and sleep quality in patients with type 2 diabetes with depressive symptoms. METHODS In this double-blind clinical trial, 60 volunteer patients (age range 20-65 years) with type 2 diabetes mellitus with symptoms of depression were randomized into the intervention (received 700 mg/day hydroalcoholic extract; n = 30) or control group (received 700 mg/day toasted flour; n = 30). Dietary intake, physical activity, anthropometric indices, FBS (Fasting blood sugar), hs-CRP(High-sensitivity C-reactiveprotein), depression, anxiety, and sleep quality were determined at the beginning and end of the study. Depression and anxiety were assessed by Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI), respectively; sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). RESULTS Sixty participants received M. officinalis extract or placebo, of which 44 patients completed the 12-week double-blind clinical trial. After 12-week the mean change of depression and anxiety scores were statistically significant between the two groups (p < 0.001 and p = 0.04, respectively), but no significant differences were observed in FBS, hs-CRP, anthropometric indices, sleep quality, and blood pressure.In the intervention group, there was a significant decrease in depression and anxiety severity(p < 0.001 and p = 0.01, respectively) at the end of the study compared to the baseline. TRIAL REGISTRATION All protocols in this study were followed in accordance with the Helsinki Declaration (1989 revision). Ethical approval for this study was obtained from the Iran University of Medical Sciences Ethics committee (IR.IUMS.FMD.REC 1396.9413468004; research.iums.ac.ir). The study was registered at the Iranian Registry of Clinical Trials (IRCT201709239472N16); Registration date: 09/10/2017.
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Affiliation(s)
- Mostafa Safari
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Hemmat Broadway, 14155-6171, Tehran, 1449614535, Iran
| | - Akbar Asadi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Hemmat Broadway, 14155-6171, Tehran, 1449614535, Iran
| | - Naheed Aryaeian
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Hemmat Broadway, 14155-6171, Tehran, 1449614535, Iran.
| | - Hasan Fallah Huseini
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, 30Th Km of Karaj-Qazvin Freeway, ACECR Research Complex, Karaj, 3365166571, Iran
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Hemmat Broadway, 14155-6171, Tehran, 1449614535, Iran
| | - Shima Jazayeri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Hemmat Broadway, 14155-6171, Tehran, 1449614535, Iran
| | - Mojtaba Malek
- Institute of Endocrinology & Metabolism, Firoozeh Alley, Vali-asrSq, Tehran, Iran
| | - Agha Fateme Hosseini
- Department of Statistics, School of Public Health, Iran University of Medical Sciences, Hemmat Broadway, Tehran, Iran
| | - Zahra Hamidi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Hemmat Broadway, 14155-6171, Tehran, 1449614535, Iran
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11
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Lee DY, Cho YH, Kim M, Jeong CW, Cha JM, Won GH, Noh JS, Son SJ, Park RW. Association between impaired glucose metabolism and long-term prognosis at the time of diagnosis of depression: Impaired glucose metabolism as a promising biomarker proposed through a machine-learning approach. Eur Psychiatry 2023; 66:e21. [PMID: 36734114 PMCID: PMC9970146 DOI: 10.1192/j.eurpsy.2023.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Predicting the course of depression is necessary for personalized treatment. Impaired glucose metabolism (IGM) was introduced as a promising depression biomarker, but no consensus was made. This study aimed to predict IGM at the time of depression diagnosis and examine the relationship between long-term prognosis and predicted results. METHODS Clinical data were extracted from four electronic health records in South Korea. The study population included patients with depression, and the outcome was IGM within 1 year. One database was used to develop the model using three algorithms. External validation was performed using the best algorithm across the three databases. The area under the curve (AUC) was calculated to determine the model's performance. Kaplan-Meier and Cox survival analyses of the risk of hospitalization for depression as the long-term outcome were performed. A meta-analysis of the long-term outcome was performed across the four databases. RESULTS A prediction model was developed using the data of 3,668 people, with an AUC of 0.781 with least absolute shrinkage and selection operator (LASSO) logistic regression. In the external validation, the AUCs were 0.643, 0.610, and 0.515. Through the predicted results, survival analysis and meta-analysis were performed; the hazard ratios of risk of hospitalization for depression in patients predicted to have IGM was 1.20 (95% confidence interval [CI] 1.02-1.41, p = 0.027) at a 3-year follow-up. CONCLUSIONS We developed prediction models for IGM occurrence within a year. The predicted results were related to the long-term prognosis of depression, presenting as a promising IGM biomarker related to the prognosis of depression.
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Affiliation(s)
- Dong Yun Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea
| | - Yong Hyuk Cho
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea.,Department of Medical Sciences, Graduate School of Ajou University, Suwon, South Korea
| | | | - Chang-Won Jeong
- Medical Convergence Research Center, Wonkwang University, Iksan, Korea
| | - Jae Myung Cha
- Department of Gastroenterology, Gang Dong Kyung Hee University Hospital, Seoul, Korea
| | - Geun Hui Won
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Jai Sung Noh
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea
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12
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Donoso F, Cryan JF, Olavarría-Ramírez L, Nolan YM, Clarke G. Inflammation, Lifestyle Factors, and the Microbiome-Gut-Brain Axis: Relevance to Depression and Antidepressant Action. Clin Pharmacol Ther 2023; 113:246-259. [PMID: 35278334 PMCID: PMC10084001 DOI: 10.1002/cpt.2581] [Citation(s) in RCA: 48] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/08/2022] [Indexed: 01/27/2023]
Abstract
Depression is considered a major public health concern, where existing pharmacological treatments are not equally effective across all patients. The pathogenesis of depression involves the interaction of complex biological components, such as the immune system and the microbiota-gut-brain axis. Adjunctive lifestyle-oriented approaches for depression, including physical exercise and special diets are promising therapeutic options when combined with traditional antidepressants. However, the mechanisms of action of these strategies are incompletely understood. Accumulating evidence suggests that physical exercise and specific dietary regimens can modulate both the immune system and gut microbiota composition. Here, we review the current information about the strategies to alleviate depression and their crosstalk with both inflammatory mechanisms and the gut microbiome. We further discuss the role of the microbiota-gut-brain axis as a possible mediator for the adjunctive therapies for depression through inflammatory mechanisms. Finally, we review existing and future adjunctive strategies to manipulate the gut microbiota with potential use for depression, including physical exercise, dietary interventions, prebiotics/probiotics, and fecal microbiota transplantation.
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Affiliation(s)
- Francisco Donoso
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, Cork, Ireland
| | - John F Cryan
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy & Neuroscience, University College Cork, Cork, Ireland
| | | | - Yvonne M Nolan
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy & Neuroscience, University College Cork, Cork, Ireland
| | - Gerard Clarke
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Psychiatry & Neurobehavioural Science, University College Cork, Cork, Ireland
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13
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Bekka E, Eyer F. Dose-related hypoglycemia in venlafaxine poisoning: a retrospective cohort study. Clin Toxicol (Phila) 2022; 60:1336-1344. [PMID: 36332110 DOI: 10.1080/15563650.2022.2138762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Several case reports describe hypoglycemia in the context of venlafaxine overdose, while investigations at therapeutic dose suggested a neutral effect on glucose homeostasis. Studies on hypoglycemia in venlafaxine intoxication are lacking. METHODS Single-center retrospective cohort study of non-diabetic patients presenting with a laboratory-confirmed antidepressant overdose to the department of clinical toxicology of a tertiary care hospital over a 12-year period. Our main goal was to investigate the association of hypoglycemia as the primary outcome with venlafaxine exposure using multiple logistic regression. Multi-drug exposures were included. We further aimed to describe the association of blood glucose (BG)/hypoglycemia with antidepressant dose, seizures and length of hospital stay. RESULTS 525 antidepressant intoxications were included, 85 of which involved venlafaxine. Hypoglycemia occurred in 34.1% (29/85) of venlafaxine intoxications and in 10.7% (47/440) of non-venlafaxine antidepressant overdoses. Venlafaxine exposure was significantly associated with hypoglycemia (adjusted odds ratio (OR): 6.6, 95% confidence interval (CI): 3.5-12.6). Venlafaxine-associated hypoglycemia was mainly mild (BG: 51-70 mg/dL), in 75.8% of cases, to moderate (BG: 31-50 mg/dL), in 20.7%, with one case of severe hypoglycemia (BG: 30 mg/dL). BG was significantly inversely correlated with dose in the venlafaxine group (Spearman's correlation coefficient: -0.47, p = 0.002) but not in other commonly prescribed antidepressants. Regardless of venlafaxine exposure, hypoglycemia was associated with seizures (adjusted OR: 5.3, 95% CI: 2.6-10.6) and with a 2.7 day increase in hospital length of stay (95% CI: 1.3-4.2). CONCLUSION A dose-related, mild to moderate hypoglycemia occurred in over one-third of venlafaxine poisonings. In overdose of other antidepressants, hypoglycemia was seen less frequently and without significant dose-dependency. Regardless of venlafaxine exposure, hypoglycemia was associated with seizures and prolonged length of stay, although these factors are likely primarily determined by other toxicities. BG monitoring in venlafaxine overdose should be considered.
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Affiliation(s)
- Elias Bekka
- Department of Internal Medicine II, Division of Clinical Toxicology and Poison Control Centre Munich, TUM School of Medicine, Technical University of Munich, Munich, Germany.,Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Florian Eyer
- Department of Internal Medicine II, Division of Clinical Toxicology and Poison Control Centre Munich, TUM School of Medicine, Technical University of Munich, Munich, Germany
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14
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Liu B, Ruz‐Maldonado I, Toczyska K, Olaniru OE, Zariwala MG, Hopkins D, Zhao M, Persaud SJ. The selective serotonin reuptake inhibitor fluoxetine has direct effects on beta cells, promoting insulin secretion and increasing beta-cell mass. Diabetes Obes Metab 2022; 24:2038-2050. [PMID: 35676820 PMCID: PMC9545812 DOI: 10.1111/dom.14791] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/23/2022] [Accepted: 06/06/2022] [Indexed: 12/05/2022]
Abstract
AIM This study investigated whether therapeutically relevant concentrations of fluoxetine, which have been shown to reduce plasma glucose and glycated haemoglobin independent of changes in food intake and body weight, regulate beta-cell function and improve glucose homeostasis. METHODS Cell viability, insulin secretion, beta-cell proliferation and apoptosis were assessed after exposure of MIN6 beta cells or isolated mouse and human islets to 0.1, 1 or 10 μmol/L fluoxetine. The effect of fluoxetine (10 mg/kg body weight) administration on glucose homeostasis and islet function was also examined in ob/ob mice. RESULTS Exposure of MIN6 cells and mouse islets to 0.1 and 1 μmol/L fluoxetine for 72 hours did not compromise cell viability but 10 μmol/L fluoxetine significantly increased Trypan blue uptake. The dose of 1 μmol/L fluoxetine significantly increased beta-cell proliferation and protected islet cells from cytokine-induced apoptosis. In addition, 1 μmol/L fluoxetine induced rapid and reversible potentiation of glucose-stimulated insulin secretion from islets isolated from mice, and from lean and obese human donors. Finally, intraperitoneal administration of fluoxetine to ob/ob mice over 14 days improved glucose tolerance and resulted in significant increases in beta-cell proliferation and enhanced insulin secretory capacity. CONCLUSIONS These data are consistent with a role for fluoxetine in regulating glucose homeostasis through direct effects on beta cells. Fluoxetine thus demonstrates promise as a preferential antidepressant for patients with concomitant occurrence of depression and diabetes.
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Affiliation(s)
- Bo Liu
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Inmaculada Ruz‐Maldonado
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & MedicineKing's College LondonLondonUK
- Comparative Medicine and Pathology, Vascular Biology and Therapeutics Program (VBT) Program in Integrative Cell Signaling and Neurobiology of Metabolism (ICSNM)Yale University School of MedicineNew HavenConnecticutUSA
| | - Klaudia Toczyska
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Oladapo E. Olaniru
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & MedicineKing's College LondonLondonUK
| | | | - David Hopkins
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Min Zhao
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Shanta J. Persaud
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & MedicineKing's College LondonLondonUK
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15
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Ayyash A, Holloway AC. Fluoxetine-induced hepatic lipid accumulation is mediated by prostaglandin endoperoxide synthase 1 and is linked to elevated 15-deoxy-Δ 12,14 PGJ 2. J Appl Toxicol 2021; 42:1004-1015. [PMID: 34897744 DOI: 10.1002/jat.4272] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/17/2021] [Indexed: 12/11/2022]
Abstract
Major depressive disorder and other neuropsychiatric disorders are often managed with long-term use of antidepressant medication. Fluoxetine, an SSRI antidepressant, is widely used as a first-line treatment for neuropsychiatric disorders. However, fluoxetine has also been shown to increase the risk of metabolic diseases such as non-alcoholic fatty liver disease. Fluoxetine has been shown to increase hepatic lipid accumulation in vivo and in vitro. In addition, fluoxetine has been shown to alter the production of prostaglandins which have also been implicated in the development of non-alcoholic fatty liver disease. The goal of this study was to assess the effect of fluoxetine exposure on the prostaglandin biosynthetic pathway and lipid accumulation in a hepatic cell line (H4-II-E-C3 cells). Fluoxetine treatment increased mRNA expression of prostaglandin biosynthetic enzymes (Ptgs1, Ptgs2, and Ptgds), PPAR gamma (Pparg), and PPAR gamma downstream targets involved in fatty acid uptake (Cd36, Fatp2, and Fatp5) as well as production of 15-deoxy-Δ12,14 PGJ2 a PPAR gamma ligand. The effects of fluoxetine to induce lipid accumulation were attenuated with a PTGS1 specific inhibitor (SC-560), whereas inhibition of PTGS2 had no effect. Moreover, SC-560 attenuated 15-deoxy-Δ12,14 PGJ2 production and expression of PPAR gamma downstream target genes. Taken together these results suggest that fluoxetine-induced lipid abnormalities appear to be mediated via PTGS1 and its downstream product 15d-PGJ2 and suggest a novel therapeutic target to prevent some of the adverse effects of fluoxetine treatment.
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Affiliation(s)
- Ahmed Ayyash
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Alison C Holloway
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
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16
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Wu CS, Hsu LY, Pan YJ, Wang SH. Associations Between Antidepressant Use and Advanced Diabetes Outcomes in Patients with Depression and Diabetes Mellitus. J Clin Endocrinol Metab 2021; 106:e5136-e5146. [PMID: 34259856 DOI: 10.1210/clinem/dgab443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Comorbid depression in patients with diabetes deteriorates the prognosis. Antidepressants might attenuate the adverse effects of depression; however, they are associated with cardiometabolic adverse effects. OBJECTIVE This study aimed to explore the association between antidepressant treatment and advanced diabetic complications and mortality among patients with depression and diabetes mellitus. METHODS We conducted a nationwide retrospective cohort study of 36 276 patients with depression and newly treated diabetes mellitus using Taiwan's universal health insurance database. Antidepressant treatment patterns within a 6-month window were classified into none, poor, partial, and regular use, and we accounted for time-dependent variables in the Cox proportional hazards regression analysis with adjustment for time-dependent comorbidity and concomitant use of medications. Different classes of antidepressants were compared. Macro- and microvascular complications, as well as all-cause mortality, were the main outcomes. Benzodiazepines were chosen as negative control exposure. RESULTS Compared with poor use of antidepressants, regular use was associated with a 0.92-fold decreased risk of macrovascular complications and a 0.86-fold decreased risk of all-cause mortality but not associated with microvascular complications. Regular use of selective serotonin reuptake inhibitors was associated with a 0.83- and 0.75-fold decreased risk of macrovascular complications and all-cause mortality, respectively. Regular use of tricyclic or tetracyclic antidepressants was associated with a 0.78-fold decreased risk of all-cause mortality. Regular use of benzodiazepine showed no association with diabetic outcomes. CONCLUSION Regular antidepressant use was associated with lower risk of advanced diabetic complications compared with poor adherence. Clinicians should emphasize antidepressant treatment adherence among patients with depression and diabetes mellitus.
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Affiliation(s)
- Chi-Shin Wu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, 100, Taiwan
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, 350, Taiwan
| | - Le-Yin Hsu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, 100, Taiwan
| | - Yi-Jiun Pan
- School of Medicine, China Medical University, Taichung, 404, Taiwan
| | - Shi-Heng Wang
- Department of Occupational Safety and Health, China Medical University, Taichung, 406, Taiwan
- Department of Public Health, China Medical University, Taichung, 406, Taiwan
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17
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Chang GR, Hou PH, Wang CM, Lin JW, Lin WL, Lin TC, Liao HJ, Chan CH, Wang YC. Imipramine Accelerates Nonalcoholic Fatty Liver Disease, Renal Impairment, Diabetic Retinopathy, Insulin Resistance, and Urinary Chromium Loss in Obese Mice. Vet Sci 2021; 8:vetsci8090189. [PMID: 34564583 PMCID: PMC8473438 DOI: 10.3390/vetsci8090189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/23/2021] [Accepted: 09/07/2021] [Indexed: 12/12/2022] Open
Abstract
Imipramine is a tricyclic antidepressant that has been approved for treating depression and anxiety in patients and animals and that has relatively mild side effects. However, the mechanisms of imipramine-associated disruption to metabolism and negative hepatic, renal, and retinal effects are not well defined. In this study, we evaluated C57BL6/J mice subjected to a high-fat diet (HFD) to study imipramine’s influences on obesity, fatty liver scores, glucose homeostasis, hepatic damage, distribution of chromium, and retinal/renal impairments. Obese mice receiving imipramine treatment had higher body, epididymal fat pad, and liver weights; higher serum triglyceride, aspartate and alanine aminotransferase, creatinine, blood urea nitrogen, renal antioxidant enzyme, and hepatic triglyceride levels; higher daily food efficiency; and higher expression levels of a marker of fatty acid regulation in the liver compared with the controls also fed an HFD. Furthermore, the obese mice that received imipramine treatment exhibited insulin resistance, worse glucose intolerance, decreased glucose transporter 4 expression and Akt phosphorylation levels, and increased chromium loss through urine. In addition, the treatment group exhibited considerably greater liver damage and higher fatty liver scores, paralleling the increases in patatin-like phospholipid domain containing protein 3 and the mRNA levels of sterol regulatory element-binding protein 1 and fatty acid-binding protein 4. Retinal injury worsened in imipramine-treated mice; decreases in retinal cell layer organization and retinal thickness and increases in nuclear factor κB and inducible nitric oxide synthase levels were observed. We conclude that administration of imipramine may result in the exacerbation of nonalcoholic fatty liver disease, diabetes, diabetic retinopathy, and kidney injury.
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Affiliation(s)
- Geng-Ruei Chang
- Department of Veterinary Medicine, National Chiayi University, 580 Xinmin Road, Chiayi 60054, Taiwan; (G.-R.C.); (C.-M.W.); (T.-C.L.); (H.-J.L.)
| | - Po-Hsun Hou
- Department of Psychiatry, Taichung Veterans General Hospital, 4 Section, 1650 Taiwan Boulevard, Taichung 40705, Taiwan;
- Faculty of Medicine, National Yang-Ming University, 2 Section, 155 Linong Street, Beitou District, Taipei 11221, Taiwan
- College of Medicine, National Chung Hsing University, 145 Xingda Road, South District, Taichung 40227, Taiwan
| | - Chao-Min Wang
- Department of Veterinary Medicine, National Chiayi University, 580 Xinmin Road, Chiayi 60054, Taiwan; (G.-R.C.); (C.-M.W.); (T.-C.L.); (H.-J.L.)
| | - Jen-Wei Lin
- Bachelor Degree Program in Animal Healthcare, Hungkuang University, 6 Section, 1018 Taiwan Boulevard, Shalu District, Taichung 433304, Taiwan; (J.-W.L.); (W.-L.L.)
| | - Wei-Li Lin
- Bachelor Degree Program in Animal Healthcare, Hungkuang University, 6 Section, 1018 Taiwan Boulevard, Shalu District, Taichung 433304, Taiwan; (J.-W.L.); (W.-L.L.)
- General Education Center, Chaoyang University of Technology, 168 Jifeng Eastern Road, Taichung 413310, Taiwan
| | - Tzu-Chun Lin
- Department of Veterinary Medicine, National Chiayi University, 580 Xinmin Road, Chiayi 60054, Taiwan; (G.-R.C.); (C.-M.W.); (T.-C.L.); (H.-J.L.)
| | - Huei-Jyuan Liao
- Department of Veterinary Medicine, National Chiayi University, 580 Xinmin Road, Chiayi 60054, Taiwan; (G.-R.C.); (C.-M.W.); (T.-C.L.); (H.-J.L.)
| | - Chee-Hong Chan
- Division of Nephrology, Chang Bing Show Chwan Memorial Hospital, 6 Lugong Road, Lukang Township, Changhua 50544, Taiwan
- Correspondence: (C.-H.C.); (Y.-C.W.); Tel.: +886-975-617071 (C.-H.C.); +886-4-2332-3456 (Y.-C.W.)
| | - Yu-Chen Wang
- Division of Cardiology, Asia University Hospital, 222 Fuxin Road, Wufeng District, Taichung 41354, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Asia University, 500 Lioufeng Road, Wufeng District, Taichung 41354, Taiwan
- Division of Cardiovascular Medicine, China Medical University Hospital, 2 Yude Road, North District, Taichung 404332, Taiwan
- College of Medicine, China Medical University, 91 Hsueh-Shih Road, North District, Taichung 404333, Taiwan
- Correspondence: (C.-H.C.); (Y.-C.W.); Tel.: +886-975-617071 (C.-H.C.); +886-4-2332-3456 (Y.-C.W.)
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18
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Luo H, Jiang ZL, Ren Y. Therapy Management of Metabolic Disorder Comorbidity With Depression. Front Psychol 2021; 12:683320. [PMID: 34408704 PMCID: PMC8366060 DOI: 10.3389/fpsyg.2021.683320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022] Open
Abstract
Depression is a common disease that seriously endangers the physical and mental health of human beings, and it often coexists with other metabolic disorders such as diabetes and cancer. There have been endless reports on the mechanism, prevention, and cure of comorbidity because of its high incidence and poor prognosis and the increased burden on the family and society. There may be a specific comorbid basis and causal relationship between depression and metabolic diseases. Depression in patients with metabolic disorders can be effectively alleviated through psychotherapy and medication. The timely and effective treatment of depression can significantly improve the quality of life of patients with metabolic disorders, reduce their psychological burden, and promote the effective treatment of metabolic diseases. This study reorganized the research progress on the management of metabolic disorder comorbidity with depression.
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Affiliation(s)
- Hua Luo
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Zheng-Li Jiang
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Yu Ren
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
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19
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Doxepin Exacerbates Renal Damage, Glucose Intolerance, Nonalcoholic Fatty Liver Disease, and Urinary Chromium Loss in Obese Mice. Pharmaceuticals (Basel) 2021; 14:ph14030267. [PMID: 33809508 PMCID: PMC8001117 DOI: 10.3390/ph14030267] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 02/07/2023] Open
Abstract
Doxepin is commonly prescribed for depression and anxiety treatment. Doxepin-related disruptions to metabolism and renal/hepatic adverse effects remain unclear; thus, the underlying mechanism of action warrants further research. Here, we investigated how doxepin affects lipid change, glucose homeostasis, chromium (Cr) distribution, renal impairment, liver damage, and fatty liver scores in C57BL6/J mice subjected to a high-fat diet and 5 mg/kg/day doxepin treatment for eight weeks. We noted that the treated mice had higher body, kidney, liver, retroperitoneal, and epididymal white adipose tissue weights; serum and liver triglyceride, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, and creatinine levels; daily food efficiency; and liver lipid regulation marker expression. They also demonstrated exacerbated insulin resistance and glucose intolerance with lower Akt phosphorylation, GLUT4 expression, and renal damage as well as higher reactive oxygen species and interleukin 1 and lower catalase, superoxide dismutase, and glutathione peroxidase levels. The treated mice had a net-negative Cr balance due to increased urinary excretion, leading to Cr mobilization, delaying hyperglycemia recovery. Furthermore, they had considerably increased fatty liver scores, paralleling increases in adiponectin, FASN, PNPLA3, FABP4 mRNA, and SREBP1 mRNA levels. In conclusion, doxepin administration potentially worsens renal injury, nonalcoholic fatty liver disease, and diabetes.
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20
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Sun JW, Hernández-Díaz S, Haneuse S, Bourgeois FT, Vine SM, Olfson M, Bateman BT, Huybrechts KF. Association of Selective Serotonin Reuptake Inhibitors With the Risk of Type 2 Diabetes in Children and Adolescents. JAMA Psychiatry 2021; 78:91-100. [PMID: 32876659 PMCID: PMC7489393 DOI: 10.1001/jamapsychiatry.2020.2762] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
IMPORTANCE Concerns exist that use of selective serotonin reuptake inhibitors (SSRIs) increases the risk of developing type 2 diabetes (T2D) in adults, but evidence in children and adolescents is limited. In the absence of a randomized clinical trial, evidence must be generated using real-world data. OBJECTIVE To evaluate the safety of SSRI use in children and adolescents with respect to the associated risk of T2D. DESIGN, SETTING, AND PARTICIPANTS This cohort study of patients aged 10 to 19 years with a diagnosis for an SSRI treatment indication was conducted within the nationwide Medicaid Analytic eXtract (MAX; January 1, 2000, to December 31, 2014) and the IBM MarketScan (January 1, 2003, to September 30, 2015) databases. Data were analyzed from November 1, 2018, to December 6, 2019. EXPOSURES New users of an SSRI medication and comparator groups with no known metabolic adverse effects (no antidepressant exposure, bupropion hydrochloride exposure, or psychotherapy exposure). Within-class individual SSRI medications were compared with fluoxetine hydrochloride. MAIN OUTCOMES AND MEASURES Incident T2D during follow-up. Intention-to-treat effects were estimated using Cox proportional hazards regression models, adjusting for confounding through propensity score stratification. As-treated effects to account for continuous treatment were estimated using inverse probability weighting and marginal structural models. RESULTS A total of 1 582 914 patients were included in the analysis (58.3% female; mean [SD] age, 15.1 [2.3] years). The SSRI-treated group included 316 178 patients in the MAX database (publicly insured; mean [SD] age, 14.7 [2.1] years; 62.2% female) and 211 460 in the MarketScan database (privately insured; mean [SD] age, 15.8 [2.3] years; 63.9% female) with at least 2 SSRI prescriptions filled, followed up for a mean (SD) of 2.3 (2.0) and 2.2 (1.9) years, respectively. In publicly insured patients, initiation of SSRI treatment was associated with a 13% increased hazard of T2DM (intention-to-treat adjusted hazard ratio [aHR], 1.13; 95% CI, 1.04-1.22) compared with untreated patients. The association strengthened for continuous SSRI treatment (as-treated aHR, 1.33; 95% CI, 1.21-1.47), corresponding to 6.6 (95% CI, 4.2-10.4) additional cases of T2D per 10 000 patients treated for at least 2 years. Adjusted HRs were lower in privately insured patients (intention-to-treat aHR, 1.01 [95% CI, 0.84-1.23]; as-treated aHR, 1.10 [95% CI, 0.88-1.36]). Findings were similar when comparing SSRI treatment with psychotherapy (publicly insured as-treated aHR, 1.44 [95% CI, 1.25-1.65]; privately insured as-treated aHR, 1.21 [95% CI, 0.93-1.57]), whereas no increased risk was observed compared with bupropion treatment publicly insured as-treated aHR, 1.01 [95% CI, 0.79-1.29]; privately insured as-treated aHR, 0.87 [95% CI, 0.44-1.70]). For the within-class analysis, no medication had an increased hazard of T2D compared with fluoxetine. CONCLUSIONS AND RELEVANCE These findings suggest that children and adolescents initiating SSRI treatment may be at a small increased risk of developing T2D, particularly publicly insured patients. The magnitude of association was more modest than previously reported, and the absolute risk was small. The potential small risk should be viewed in relation to the efficacy of SSRIs for its major indications in young patients.
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Affiliation(s)
- Jenny W. Sun
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts,Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Sonia Hernández-Díaz
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | | | - Seanna M. Vine
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mark Olfson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Brian T. Bateman
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts,Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Krista F. Huybrechts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts,Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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Raja SY, Ghori U, Naqvi HA, Aijaz S, Anwar A, Hashmi AA. Factors for Social Stressors Among Type 2 Diabetics Versus Non-Diabetics Using the Hamilton Depression Rating Scale. Cureus 2020; 12:e11861. [PMID: 33409095 PMCID: PMC7781553 DOI: 10.7759/cureus.11861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective This study aimed to evaluate different factors of social stressors among people with type II diabetes versus non-diabetics by using the Hamilton Depression Rating Scale (HAM-D). Methodology This case-control study was done for one year at Ziauddin University Hospital, Karachi, Pakistan. Diagnosed patients with type II diabetes between 25 and 60 years were included as cases and age-related healthy individuals as controls. Participants on any psychotropic medications, neurodegenerative disorders, or on chemotherapy were excluded. Hamilton Rating Scale for Depression (HRDS-17) was used for recording depressive symptoms. The Statistical Package for the Social Sciences (SPSS) version 26.0 (IBM Corp., Armonk, NY) was used for data analysis. The frequency was calculated for descriptive statistics and depression scores (HRDS-17). A significance level of 0.05 was considered. Results A total of 272 patients were divided into two groups, with 136 patients in the group with diabetes and 136 participants in the control group. The mean age among people with diabetes was 55.13±9.10 years and among non-diabetics was 43.25±12.97 years (p<0.001). The mean duration of illness in people with diabetes was 8.51±7.57 years and in non-diabetics, it was 6.73±4.42 years (p=0.018). The mean social rating in people with diabetes was 164.0±155.60 and in non-diabetics, it was 124.75±99.02 (p=0.014). Insomnia, both in the early and middle part of the night affecting work activities, hypochondriasis, and loss of weight, was significantly present among diabetics as compared to controls (p<0.05). Conclusion Most diabetics reported a significant effect on the quality of life based on social rating and health-care expenditure. They experienced depressive symptoms more frequently than non-diabetics. Insomnia in the middle of the night affected work and activities; hypochondriasis and weight loss were found to be substantially higher among patients with diabetes than in controls.
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Affiliation(s)
- Saadia Y Raja
- Internal Medicine, Ziauddin University, Karachi, PAK
| | - Uzma Ghori
- Internal Medicine, Ziauddin University, Karachi, PAK
| | | | - Sadaf Aijaz
- Psychiatry, Northern Border University, Arar, SAU
| | - Adnan Anwar
- Physiology, Al-Tibri Medical College, Isra University, Karachi, PAK
| | - Atif A Hashmi
- Pathology, Liaquat National Hospital and Medical College, Karachi, PAK
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A unique insight for energy metabolism disorders in depression based on chronic unpredictable mild stress rats using stable isotope-resolved metabolomics. J Pharm Biomed Anal 2020; 191:113588. [DOI: 10.1016/j.jpba.2020.113588] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/15/2020] [Accepted: 08/20/2020] [Indexed: 12/22/2022]
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Essmat N, Soliman E, Mahmoud MF, Mahmoud AAA. Antidepressant activity of anti-hyperglycemic agents in experimental models: A review. Diabetes Metab Syndr 2020; 14:1179-1186. [PMID: 32673838 DOI: 10.1016/j.dsx.2020.06.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Diabetes Mellitus (DM) and depression occur comorbidly and share some pathophysiological mechanisms. The course of depression in patients with the two conditions is severe. Treatment of depression in diabetic patients requires special attention because most of psychopharmacological agents can worsen glycemic control. This article aims to review studies evaluating the antidepressant effect of anti-hyperglycemic agents from preclinical perspective. METHODS A literature search was performed with PubMed and Google Scholar using relevant keywords (antidiabetic; diabetes; depression; antidepressant; animals) to extract relevant studies evaluating the antidepressant activity of anti-hyperglycemic agents in experimental models. RESULTS Several studies have reported that some traditional anti-hyperglycemic agents reduce depression-like behavior in the absence or presence of diabetes. These drugs include insulin, glyburide, metformin, pioglitazone, vildagliptin, liraglutide, and exenatide. The antidepressant activity of anti-hyperglycemic agents may be mediated by reducing the blood glucose level, ameliorating the central oxidative stress and inflammation, and regulating the hypothalamic-pituitary-adrenal axis (HPAA). CONCLUSIONS Drugs which have both antidiabetic and antidepressant activities can provide better treatment strategy for patients with diabetes-associated depression. However, further research studies are still required in human subjects.
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Affiliation(s)
- Nariman Essmat
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Eman Soliman
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt.
| | - Mona F Mahmoud
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Amr A A Mahmoud
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt; Department of Pharmacology, Pharmacy Program, Oman College of Health Sciences, Muscat, 114, Oman
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24
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Turan Yücel N, Can ÖD, Demir Özkay Ü. Catecholaminergic and opioidergic system mediated effects of reboxetine on diabetic neuropathic pain. Psychopharmacology (Berl) 2020; 237:1131-1145. [PMID: 31912189 DOI: 10.1007/s00213-019-05443-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/27/2019] [Indexed: 10/25/2022]
Abstract
RATIONALE Current data indicate that the noradrenergic system plays a critical role in neuropathic pain treatment. Notably, drugs that directly affect this system may have curative potential in neuropathy-associated pain. OBJECTIVES The aim of this study was to evaluate the potential therapeutic efficacy of reboxetine, a potent and selective noradrenaline reuptake inhibitor, on hyperalgesia and allodynia responses in rats with experimental diabetes. Furthermore, mechanistic studies were performed to elucidate the possible mode of actions. METHODS Experimental diabetes was induced by a single dose of streptozotocin. Mechanical hyperalgesia, mechanical allodynia, thermal hyperalgesia, and thermal allodynia responses in diabetic rats were evaluated by Randall-Selitto, dynamic plantar, Hargreaves, and warm plate tests, respectively. RESULTS Reboxetine treatment (8 and 16 mg/kg for 2 weeks) demonstrated an effect comparable to that of the reference drug, pregabalin, improving the hyperalgesic and allodynic responses secondary to diabetes mellitus. Pretreatment with phentolamine, metoprolol, SR 59230A, and atropine did not alter the abovementioned effects of reboxetine; however, the administration of α-methyl-para-tyrosine methyl ester, propranolol, ICI-118,551, SCH-23390, sulpiride, and naltrindole significantly inhibited these effects. Moreover, reboxetine did not induce a significant difference in the rat plasma glucose levels. CONCLUSIONS Our findings indicate that the antihyperalgesic and antiallodynic effects of reboxetine are mediated by the catecholaminergic system; β2-adrenoceptors; D1-, D2/D3-dopaminergic receptors; and δ-opioid receptors. The results suggest that this analgesic effect of reboxetine, besides its neutral profile on glycemic control, may be advantageous in the pharmacotherapy of diabetic neuropathy-induced pain.
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Affiliation(s)
- Nazlı Turan Yücel
- Department of Pharmacology, Faculty of Pharmacy, Anadolu University, 26470, Eskisehir, Turkey.
| | - Özgür Devrim Can
- Department of Pharmacology, Faculty of Pharmacy, Anadolu University, 26470, Eskisehir, Turkey
| | - Ümide Demir Özkay
- Department of Pharmacology, Faculty of Pharmacy, Anadolu University, 26470, Eskisehir, Turkey
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Sun LN, Liu XL. Functions of adiponectin signaling in regulating neural plasticity and its application as the therapeutic target to neurological and psychiatric diseases. Rev Neurosci 2020; 30:485-495. [PMID: 30864396 DOI: 10.1515/revneuro-2018-0062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 10/06/2018] [Indexed: 12/15/2022]
Abstract
Convergent lines of evidence indicate the critical roles of adiponectin in regulating neural functions on different levels. Because of the importance in maintaining neural plasticity including adult neurogenesis and synaptic plasticity, adiponectin has the potential to serve as the treatment targets in therapies of neurological and psychiatric disorders. Hence, systematic review is needed to summarize how adiponectin works in the brain, and how the adiponectin pathway is employed as the treatment method needs to be determined. Moreover, the benefits of adiponectin as the regulator for neural plasticity such as synaptic plasticity and neurogenesis have been supported by many literatures. In the current article, we reviewed the functions of adiponectin in different types of neural plasticity. We also demonstrated the potential value of adiponectin as the treatment target for different types of neurodegenerative and psychiatric disorders. Taken together, this review offers a new insight about adiponectin as the ideal target to develop the new treatment methods against neurodegeneration or psychiatric diseases.
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Affiliation(s)
- Li-Na Sun
- School of PE and Sport, Beijing Normal University, Beijing 100875, China
| | - Xiao-Li Liu
- School of PE and Sport, Beijing Normal University, Beijing 100875, China
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26
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Bampi SR, Casaril AM, Domingues M, de Andrade Lourenço D, Pesarico AP, Vieira B, Begnini KR, Seixas FK, Collares TV, Lenardão EJ, Savegnago L. Depression-like behavior, hyperglycemia, oxidative stress, and neuroinflammation presented in diabetic mice are reversed by the administration of 1-methyl-3-(phenylselanyl)-1H-indole. J Psychiatr Res 2020; 120:91-102. [PMID: 31654972 DOI: 10.1016/j.jpsychires.2019.10.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/24/2019] [Accepted: 10/03/2019] [Indexed: 02/08/2023]
Abstract
Oxidative stress and neuroinflammation are found both in diabetes mellitus and major depressive disorder (MDD). In addition to damage in peripheral organs, such as liver and kidney, diabetic patients have a higher risk of developing depression. In this sense, the objective of the present study was to characterize the antidepressant-like effect of a selenium-containing compound, the 1-methyl-3-(phenylselanyl)-1H-indole (MFSeI), in streptozotocin (STZ)-induced diabetic mice. STZ (200 mg/kg, i.p.) was used to induce diabetes mellitus type I, and after seven days, the administration of MFSeI (10 mg/kg, i.g.) was initiated and followed for the next 14 days. Twenty-four hours after the last administration of MFSeI, the behavioral tests were performed, followed by euthanasia. The treatment with MFSeI was able to reverse the hyperglycemia induced by STZ. MFSeI also decreased the plasma levels of biomarkers of liver and kidney damage. Importantly, MFSeI reversed the depression-like behavior induced by STZ in the tail suspension test and forced swimming test without promoting locomotor alterations. Furthermore, MFSeI reversed the increased levels of reactive species and lipid peroxidation in the prefrontal cortex (PFC), hippocampus (HC), liver, and kidney of STZ-treated mice. Treatment with MFSeI also decreased the expression of tumor necrosis factor-alpha, inducible nitric oxide synthase and indoleamine 2,3-dioxygenase, while increasing the expression of interleukin-10, insulin receptor substrate-1 and glucose transport-4 in the PFC and HC of mice. Taken together, the results indicate the effectiveness of MFSeI against depression-like behavior and central and peripheral complications caused by diabetes in mice.
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Affiliation(s)
- Suely Ribeiro Bampi
- Neurobiotechnology Research Group, Center of Biotechnology, Federal University of Pelotas, RS, Brazil
| | - Angela Maria Casaril
- Neurobiotechnology Research Group, Center of Biotechnology, Federal University of Pelotas, RS, Brazil
| | - Micaela Domingues
- Neurobiotechnology Research Group, Center of Biotechnology, Federal University of Pelotas, RS, Brazil
| | | | - Ana Paula Pesarico
- Neurobiotechnology Research Group, Center of Biotechnology, Federal University of Pelotas, RS, Brazil
| | - Beatriz Vieira
- Laboratory of Clean Organic Synthesis, Center of Chemical, Pharmaceutical and Food Sciences, Federal University of Pelotas, RS, Brazil
| | - Karine Rech Begnini
- Cellular and Molecular Oncology Research Group, Center of Biotechnology, Federal University of Pelotas, RS, Brazil
| | - Fabiana K Seixas
- Cellular and Molecular Oncology Research Group, Center of Biotechnology, Federal University of Pelotas, RS, Brazil
| | - Tiago Veiras Collares
- Cellular and Molecular Oncology Research Group, Center of Biotechnology, Federal University of Pelotas, RS, Brazil
| | - Eder João Lenardão
- Laboratory of Clean Organic Synthesis, Center of Chemical, Pharmaceutical and Food Sciences, Federal University of Pelotas, RS, Brazil
| | - Lucielli Savegnago
- Neurobiotechnology Research Group, Center of Biotechnology, Federal University of Pelotas, RS, Brazil.
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Cikánková T, Fišar Z, Hroudová J. In vitro effects of antidepressants and mood-stabilizing drugs on cell energy metabolism. Naunyn Schmiedebergs Arch Pharmacol 2019; 393:797-811. [PMID: 31858154 DOI: 10.1007/s00210-019-01791-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 12/05/2019] [Indexed: 01/16/2023]
Abstract
The evaluation of drug-induced mitochondrial impairment may be important in drug development as well as in the comprehension of molecular mechanisms of the therapeutic and adverse effects of drugs. The primary aim of this study was to investigate the effects of four drugs for treatment of depression (bupropion, fluoxetine, amitriptyline, and imipramine) and five drugs for bipolar disorder treatment (lithium, valproate, valpromide, lamotrigine, and carbamazepine) on cell energy metabolism. The in vitro effects of the selected psychopharmaca were measured in isolated pig brain mitochondria; the activities of citrate synthase (CS) and electron transport chain (ETC) complexes (I, II + III, and IV) and mitochondrial respiration rates linked to complex I and complex II were measured. Complex I was significantly inhibited by lithium, carbamazepine, fluoxetine, amitriptyline, and imipramine. The activity of complex IV was decreased after exposure to carbamazepine. The activities of complex II + III and CS were not affected by any tested drug. Complex I-linked respiration was significantly inhibited by bupropion, fluoxetine, amitriptyline, imipramine, valpromide, carbamazepine, and lamotrigine. Significant inhibition of complex II-linked respiration was observed after mitochondria were exposed to amitriptyline, fluoxetine, and carbamazepine. Our outcomes confirm the need to investigate the effects of drugs on both the total respiration rate and the activities of individual enzymes of the ETC to reveal the risk of adverse effects as well as to understand the molecular mechanisms leading to drug-induced changes in the respiratory rate. Our approach can be further replicated to study the mechanisms of action of newly developed drugs.
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Affiliation(s)
- Tereza Cikánková
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Ke Karlovu 11, 120 00, Prague 2, Czech Republic
| | - Zdeněk Fišar
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Ke Karlovu 11, 120 00, Prague 2, Czech Republic
| | - Jana Hroudová
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Ke Karlovu 11, 120 00, Prague 2, Czech Republic. .,Institute of Pharmacology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Albertov 4, 128 00, Prague 2, Czech Republic.
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Dandjinou M, Sheehy O, Bérard A. Antidepressant use during pregnancy and the risk of gestational diabetes mellitus: a nested case-control study. BMJ Open 2019; 9:e025908. [PMID: 31575566 PMCID: PMC6830475 DOI: 10.1136/bmjopen-2018-025908] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The aim of this study was to determine the association between antidepressant (AD) classes, types and duration of use during pregnancy and the risk of gestational diabetes mellitus (GDM). DESIGN AND SETTING A nested case-control study was conducted within the Quebec Pregnancy Cohort (QPC), a Canadian provincial database which includes data on all pregnancies and children in Quebec from January 1998 to December 2015. PRIMARY OUTCOME MEASURES Gestational diabetes mellitus. PARTICIPANTS Cases of GDM were identified after week 20 of pregnancy and randomly matched 1:10 to controls on gestational age at index date (ie, calendar date of GDM) and year of pregnancy. AD exposure was assessed by filled prescriptions between the beginning of pregnancy (first day of last menstrual period) and index date. Conditional logistic regression models were used to estimate crude and adjusted odds ratios (aOR). RESULTS Among 20 905 cases and 209 050 matched controls, 9741 (4.2%) women were exposed to ADs. When adjusting for potential confounders, AD use was associated with an increased risk of GDM (aOR 1.19, 95% CI 1.08 to 1.30); venlafaxine (aOR 1.27, 95% CI 1.09 to 1.49) and amitriptyline (aOR 1.52, 95% CI 1.25 to 1.84) were also associated with an increased risk of GDM. Moreover, the risk of GDM was increased with longer duration of AD use, specifically for serotonin norepinephrine reuptake inhibitors, tricyclic ADs and combined use of two AD classes. No statistically significant association was observed for selective serotonin reuptake inhibitors. CONCLUSION The findings suggest that ADs-and specifically venlafaxine and amitriptyline-were associated with an increased risk of GDM.
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Affiliation(s)
- Maëlle Dandjinou
- Research Center, CHU Sainte-Justine, Montreal, Quebec, Canada
- Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada
| | - Odile Sheehy
- Research Center, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Anick Bérard
- Research Center, CHU Sainte-Justine, Montreal, Quebec, Canada
- Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada
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Mikhailova EV, Romanova IV, Derkach KV, Vishnevskaya ON, Shpakov AO. The Effect of Diet-Induced and Melanocortin Obesity on Expression of Tryptophan Hydroxylase 2 in the Dorsal Raphe Nucleus and Ventral Tegmental Area in Mice. J EVOL BIOCHEM PHYS+ 2019. [DOI: 10.1134/s0022093019040057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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30
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Fugger G, Dold M, Bartova L, Kautzky A, Souery D, Mendlewicz J, Serretti A, Zohar J, Montgomery S, Frey R, Kasper S. Major Depression and Comorbid Diabetes - Findings from the European Group for the Study of Resistant Depression. Prog Neuropsychopharmacol Biol Psychiatry 2019; 94:109638. [PMID: 31054944 DOI: 10.1016/j.pnpbp.2019.109638] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/01/2019] [Accepted: 04/30/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The major aim of this multicenter study of the European Group for the Study of Resistant Depression (GSRD) was to elucidate associations between major depressive disorder (MDD) and comorbid diabetes. METHODS Demographic and clinical information of 1410 patients with a primary MDD diagnosis according to DSM-IV were retrieved cross-sectionally between 2012 and 2016. By applying descriptive statistics, analyses of covariance (ANCOVA) and binary logistic regression analyses, a comparison between patient characteristics with and without comorbid diabetes was performed. RESULTS The point prevalence rate for comorbid diabetes across MDD patients was 6%. Individuals with MDD + comorbid diabetes were significantly older, heavier, more likely to be inpatient and diagnosed with additional comorbid chronic somatic diseases. In addition, current suicide risk was significantly increased and melancholic features were more likely pronounced. In general, patients in the MDD + diabetes group received a combination therapy with at least one additional antidepressant rather than various other augmentation strategies. CONCLUSION Our analyses depict a lower prevalence rate of diabetes in MDD patients than previous studies. However, in light of the prevalence of diabetes in the geographical area of the study, we found an increased risk for individuals with depression compared to the general population. Current suicide risk is markedly elevated and has to be thoroughly assessed in every patient with comorbid diabetes. Depression severity and treatment response remained unaffected by concurrent diabetes in MDD.
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Affiliation(s)
- Gernot Fugger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Markus Dold
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Lucie Bartova
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Alexander Kautzky
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Daniel Souery
- Université Libre de Bruxelles, Bruxelles, Belgium; Psy Pluriel Centre Européen de Psychologie Médicale, Bruxelles, Belgium
| | | | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Joseph Zohar
- Psychiatric Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | - Richard Frey
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
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Omidian M, Mahmoudi M, Abshirini M, Eshraghian MR, Javanbakht MH, Zarei M, Hasani H, Djalali M. Effects of vitamin D supplementation on depressive symptoms in type 2 diabetes mellitus patients: Randomized placebo-controlled double-blind clinical trial. Diabetes Metab Syndr 2019; 13:2375-2380. [PMID: 31405646 DOI: 10.1016/j.dsx.2019.06.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 06/10/2019] [Indexed: 10/26/2022]
Abstract
AIM Diabetes increases the odds of depression and depression is often associated with poor glycemic control and complications of diabetes. Vitamin D is also believed to improve glycemic control and ameliorate depressive symptoms. Therefore, we examined effects of vitamin D monotherapy (without antidepressant drugs) on depressive symptoms in Type 2 diabetic patients with mild to moderate depressive symptoms. METHODS We conducted 12 weeks, placebo-controlled, double-blind, randomized trial on 68 subjects with T2DM and mild to moderate depressive symptoms. Subjects received 100 μg (4000 IU) vitamin D (n = 32) or placebo (n = 34) daily. Beck Depression Inventory-II (BDI-II-PERSIAN) was applied for assessment of the severity of depression. Depression scores and metabolic profiles were measured at the beginning and end of trail. RESULTS after 3 months of vitamin D supplementation, mean values of 25(OH) D increased from 15.5 ± 8.8 to 32.2 ± 8.9 ng/ml (p-value <0.001) in the vitamin D group. Moreover, BDI-II scores decreased from 15.2 ± 9.6 to 9.8 ± 7.2 (p-value <0.001) in the vitamin D group and 15.5 ± 11.2 to 13.7 ± 11.5 (p-value = 0.03) in placebo group. This decrease in BDI-II scores were significant (27.6% vs 10.8%) compared with placebo (p-value = 0.02). In term of metabolic profiles, mean change in level of Hemoglobin A1c (HbA1c), insulin and triglycerides (TG) were significantly higher in response to the treatment with vitamin D compared to placebo (p-value <0.02). CONCLUSIONS In conclusion, supplementation of vitamin D in T2DM patients may protect these patients against the onset of major depressive disorder (MDD), with noticeable favorable effects on measures of metabolic profiles. TRIAL REGISTRATION NCT03008057.
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Affiliation(s)
- Mahsa Omidian
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Mahmoudi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Abshirini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Eshraghian
- Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Javanbakht
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Zarei
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Hasani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Djalali
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Li HQ, Chi S, Dong Q, Yu JT. Pharmacotherapeutic strategies for managing comorbid depression and diabetes. Expert Opin Pharmacother 2019; 20:1589-1599. [PMID: 31149850 DOI: 10.1080/14656566.2019.1622090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: The increasing prevalence of comorbid depression and diabetes exerts a heavy burden on global health. Co-occurrence of depression and diabetes is common, affecting 14% to 35.8% of patients with diabetes, leading to a higher mortality and morbidity rate, more micro- and macro-vascular diseases and more cognitive decline. Areas covered: In this paper, the authors address various areas from epidemiology, the association between depression and diabetes, treatment strategies and future directions based on the currently available literature to provide novel insight into the pharmacotherapeutic management of comorbid depression and diabetes. Expert opinion: Pharmacotherapy can help patients with comorbid depression and diabetes by relieving depressive symptoms and improving glycemic control. When combined with psychological therapy, as a collaborative care effort, pharmacological therapy based on selective serotonin reuptake inhibitors (SSRIs) is recommended for comorbid depression with diabetes. Furthermore, studies with larger sample sizes that can help to define different subtypes of diabetes and severity of depression are needed so that clinicians can draw up a precise and applicable management guidelines for the personalized therapy of these diseases.
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Affiliation(s)
- Hong-Qi Li
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University , Shanghai , China
| | - Song Chi
- Department of Neurology, The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University , Shanghai , China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University , Shanghai , China
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Clark CE, Rasgon NL, Reed DE, Robakis TK. Depression precedes, but does not follow, gestational diabetes. Acta Psychiatr Scand 2019; 139:311-321. [PMID: 30561785 DOI: 10.1111/acps.12998] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To determine whether past history of depression is associated with increased rates of gestational diabetes, and whether history of gestational diabetes is associated with increased rates of postpartum depression. RESEARCH DESIGN Data for this case-control study consisted of de-identified chart records for 1439 women who received pregnancy care at a large university hospital between 1998 and 2017. RESULTS A history of depression prior to pregnancy was associated with gestational diabetes requiring insulin, although not with subtler degrees of gestational hyperglycemia. Diabetes in pregnancy was not associated with an increased risk of postpartum depression. Trauma history was associated with both impaired glucose tolerance in pregnancy and postpartum depression. CONCLUSIONS Past episodes of depression increase risk for the most severe form of gestational diabetes; however, gestational diabetes does not contribute significantly to risk for postpartum depression. This suggests a unidirectional association, unlike the bidirectional association of diabetes with depression among the general population. History of trauma increases risk for both gestational hyperglycemia and postpartum depression, suggesting important health effects of trauma that may differ measurably from those associated with depression.
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Affiliation(s)
- Claire E Clark
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Natalie L Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - David E Reed
- Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Thalia K Robakis
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Brouwer A, van Raalte DH, Nguyen HT, Rutters F, van de Ven PM, Elders PJM, Moll AC, Van Someren EJW, Snoek FJ, Beekman ATF, Bremmer MA. Effects of Light Therapy on Mood and Insulin Sensitivity in Patients With Type 2 Diabetes and Depression: Results From a Randomized Placebo-Controlled Trial. Diabetes Care 2019; 42:529-538. [PMID: 30796110 DOI: 10.2337/dc18-1732] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 01/19/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Depression is common in patients with type 2 diabetes and adversely affects quality of life and diabetes outcomes. We assessed whether light therapy, an antidepressant, improves mood and insulin sensitivity in patients with depression and type 2 diabetes. RESEARCH DESIGN AND METHODS This randomized, double-blind, placebo-controlled trial included 83 patients with depression and type 2 diabetes. The intervention comprised 4 weeks of light therapy (10,000 lux) or placebo light therapy daily at home. Primary outcomes included depressive symptoms (Inventory of Depressive Symptomatology [IDS]) and insulin sensitivity (M-value derived from the results of a hyperinsulinemic-euglycemic clamp). Secondary outcomes were related psychological and glucometabolic measures. RESULTS Intention-to-treat analysis showed that light therapy was not superior to placebo in reducing depressive symptoms (-3.9 IDS points [95% CI -9.0 to 1.2]; P = 0.248) and had no effect on insulin sensitivity (0.15 mg/kg*min [95% CI -0.41 to 0.70]; P = 0.608). Analyses incorporating only those participants who accurately adhered to the light therapy protocol (n = 51) provided similar results, but did suggest positive effects of light therapy on depression response rates (≥50% reduction in IDS points) (26% more response; P = 0.031). Prespecified analysis showed effect moderation by baseline insulin sensitivity (P = 0.009) and use of glucose-lowering medication (P = 0.023). Light therapy did not affect depressive symptoms in participants with higher insulin sensitivity or those who use only oral glucose-lowering medication or none at all, but it did produce a relevant effect in participants with lower insulin sensitivity (-12.9 IDS points [95% CI -21.6 to -4.2]; P = 0.017) and a trend toward effectiveness in those using insulin (-12.2 IDS points [95% CI -21.3 to -3.1]; P = 0.094). Light therapy was well tolerated. CONCLUSIONS Although this trial is essentially inconclusive, secondary analyses indicate that light therapy might be a promising treatment for depression among a subgroup of highly insulin-resistant individuals with type 2 diabetes.
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Affiliation(s)
- Annelies Brouwer
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Daniel H van Raalte
- Amsterdam UMC, Vrije Universiteit, Department of Internal Medicine, Diabetes Center, Amsterdam, the Netherlands
| | - Hoang-Ton Nguyen
- Amsterdam UMC, Vrije Universiteit, Department of Ophthalmology, Amsterdam, the Netherlands
| | - Femke Rutters
- Amsterdam UMC, Vrije Universiteit, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Peter M van de Ven
- Amsterdam UMC, Vrije Universiteit, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Petra J M Elders
- Amsterdam UMC, Vrije Universiteit, Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Annette C Moll
- Amsterdam UMC, Vrije Universiteit, Department of Ophthalmology, Amsterdam, the Netherlands
| | - Eus J W Van Someren
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands.,Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, the Netherlands.,Amsterdam UMC, Vrije Universiteit, Department of Integrative Neurophysiology, Centre for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Frank J Snoek
- Amsterdam UMC, Vrije Universiteit and University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Marijke A Bremmer
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands
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Visco DB, Manhães-de-Castro R, Chaves WF, Lacerda DC, Pereira SDC, Ferraz-Pereira KN, Toscano AE. Selective serotonin reuptake inhibitors affect structure, function and metabolism of skeletal muscle: A systematic review. Pharmacol Res 2018; 136:194-204. [DOI: 10.1016/j.phrs.2018.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/01/2018] [Accepted: 09/04/2018] [Indexed: 12/14/2022]
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Jacob L, Haro JM, Koyanagi A. Post-traumatic stress symptoms are associated with physical multimorbidity: Findings from the Adult Psychiatric Morbidity Survey 2007. J Affect Disord 2018. [PMID: 29522958 DOI: 10.1016/j.jad.2018.02.063] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Studies on the association between symptoms of post-traumatic stress disorder (PTSD) and physical multimorbidity (i.e., ≥2 chronic conditions) are lacking. Thus, we assessed the association between PTSD symptoms and physical multimorbidity using nationally representative, community-based data of the UK adult population. METHODS Data from the 2007 Adult Psychiatric Morbidity Survey were analyzed. PTSD symptoms were assessed using the 10-item Trauma Screening Questionnaire (TSQ). A total score of ≥6 points indicated a probable PTSD. Information was collected on 20 doctor/other health professional diagnosed physical health conditions that were present in the past 12 months. Multimorbidity was defined as ≥2 physical diseases. Multivariable logistic regression and mediation analyses were conducted to analyze the association between PTSD and physical multimorbidity, and the influence of behavioral and psychological factors in this association. RESULTS Among 7403 individuals aged ≥16 years [mean age (SD) = 46.3 (18.6) years; 51.5% females], the prevalence of PTSD increased from 2.1% in individuals with no physical conditions to 5.4% in those with ≥4 physical conditions. After adjustment for sociodemographic factors and lifetime occurrence of a traumatic event, PTSD was associated with higher odds for physical multimorbidity (Odds Ratio [OR] = 2.47; 95% Confidence Interval [CI]: 1.71-3.56). Anxiety, depression, and disordered eating explained 35%, 21%, and 8% of the PTSD-multimorbidity association, respectively. LIMITATIONS Causality or temporal associations cannot be established due to the cross-sectional nature of the study. In addition, PTSD and physical conditions were assessed using self-reports. CONCLUSIONS PTSD symptoms may be risk factors for physical multimorbidity. Anxiety and depressive symptoms might play an important role in this association. Screening for chronic physical conditions among individuals with PTSD and treating them simultaneously may lead to better clinical outcomes.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Paris 5, 15 rue de l'École de Médecine, Paris 75006, France.
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
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Framingham coronary score in individuals with symptoms or diagnoses of mental disorders: A review and meta-analysis. Psychiatry Res 2018; 263:41-47. [PMID: 29494881 DOI: 10.1016/j.psychres.2018.02.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 02/02/2018] [Accepted: 02/14/2018] [Indexed: 01/07/2023]
Abstract
Patients with mental disorders have a higher coronary morbidity and mortality as compared to the general population. However, it remains unclear whether their coronary risk scores are higher than those of the general population. We reviewed studies and meta-analyze case-control studies about coronary risk scores in individuals with symptoms or diagnoses of mental disorders. Search was performed in Pubmed and clinical trial registration databases. Four case-control studies were identified, comprising 963 individuals with symptoms or diagnoses of mental disorders and 1681 controls. They focused on the most validated coronary risk score, the Framingham Risk Score 1998 (FRS 1998). The mean FRS 1998 was significantly higher in individuals with symptoms or diagnoses of mental disorders than in the general population 7.9( ± 6.9) vs. 5.0( ± 4.8). FRS 1998 differs between individuals with symptoms or diagnoses of mental disorders and controls (Mean difference:1.84 [95% CI:0.57-3.11], p = 0.005]; high heterogeneity was observed (I2= 78%; p < 0.003). The difference was driven by three FRS 1998 criteria: smoking, diabetes and HDL cholesterolemia. The mean FRS 1998 was significantly higher in men, and to a trend in women. In conclusion, individuals with symptoms or diagnoses of mental disorders have a higher coronary risk score than controls. The FRS 1998 should be used as a simple and objective way of monitoring coronary risk in order to improve prevention of coronary events in psychiatric settings.
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Glintborg D, Altinok ML, Ravn P, Stage KB, Højlund K, Andersen M. Adrenal activity and metabolic risk during randomized escitalopram or placebo treatment in PCOS. Endocr Connect 2018; 7:479-489. [PMID: 29472241 PMCID: PMC5861369 DOI: 10.1530/ec-18-0077] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 02/22/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND/AIMS Polycystic ovary syndrome (PCOS) is associated with insulin resistance, adrenal hyperactivity and decreased mental health. We aimed to investigate the changes in adrenal activity, metabolic status and mental health in PCOS during treatment with escitalopram or placebo. METHODS Forty-two overweight premenopausal women with PCOS and no clinical depression were randomized to 12-week SSRI (20 mg escitalopram/day, n = 21) or placebo (n = 21). Patients underwent clinical examination, fasting blood samples, adrenocorticotroph hormone (ACTH) test, 3-h oral glucose tolerance test (OGTT) and filled in questionnaires regarding mental health and health-related quality of life (HRQoL): WHO Well-Being Index (WHO-5), Major Depression Inventory (MDI), Short Form 36 (SF-36) and PCOS questionnaire. RESULTS Included women were aged 31 (6) years (mean (s.d.)) and had body mass index (BMI) 35.8 (6.5) kg/m2 and waist 102 (12) cm. Escitalopram was associated with increased waist (median (quartiles) change 1 (0; 3) cm), P = 0.005 vs change during placebo and increased cortisol levels (cortisol 0, cortisol 60, peak cortisol and area under the curve for cortisol during ACTH test), all P < 0.05 vs changes during placebo. Escitalopram had no significant effect on measures of insulin sensitivity, insulin secretion, fasting lipids, mental health or HRQoL. CONCLUSION Waist circumference and cortisol levels increased during treatment with escitalopram in women with PCOS and no clinical depression, whereas metabolic risk markers, mental health and HRQol were unchanged.
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Affiliation(s)
- Dorte Glintborg
- Department of Endocrinology and MetabolismOdense University Hospital, Odense, Denmark
| | - Magda Lambaa Altinok
- Department of Endocrinology and MetabolismOdense University Hospital, Odense, Denmark
| | - Pernille Ravn
- Department of Gynecology and ObstetricsOdense University Hospital, Odense, Denmark
| | | | - Kurt Højlund
- Department of Endocrinology and MetabolismOdense University Hospital, Odense, Denmark
| | - Marianne Andersen
- Department of Endocrinology and MetabolismOdense University Hospital, Odense, Denmark
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Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an overview of shared dysregulation of the hypothalamic-pituitary-adrenal (HPA) and brain-gut-microbiome (BGM) axes associated with depression and type 2 diabetes (T2D). Clinical implications and future research are also discussed. RECENT FINDINGS Both depression and T2D are associated with dysregulation of the HPA and BGM axes. These pathways regulate immune function, glucose metabolism, and sleep, which are altered in both illnesses. Dysregulation of homeostatic brain-body pathways may be positively influenced through different therapeutic actions, including psychotherapy, healthy eating, physical activity, sleep promotion, and certain anti-inflammatory or antidepressant medications. While the causal nature of the relationship between depression and T2D remains unclear, these conditions share dysregulation of homeostatic brain-body pathways that are central to mental and physical health. Better understanding of this dysregulation may provide opportunities for interventions that could benefit both conditions. Future research should examine the additive burden of depression and T2D on HPA and BGM dysregulation and better differentiate depression from emotional distress.
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Affiliation(s)
- Claire J Hoogendoorn
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA.
| | - Juan F Roy
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA
- Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
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Concomitant Use of Atypical Antipsychotics With Other Psychotropic Medication Classes and the Risk of Type 2 Diabetes Mellitus. J Am Acad Child Adolesc Psychiatry 2017; 56:642-651. [PMID: 28735693 DOI: 10.1016/j.jaac.2017.04.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 04/15/2017] [Accepted: 05/01/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE More than half of youth treated with atypical antipsychotic (AAP) medications are also treated with concomitant antidepressants or stimulants. This study assessed the association between antidepressant or stimulant use concomitant with AAPs and the risk of incident type 2 diabetes mellitus (T2DM). METHOD Medicaid Analytic eXtract data were used to conduct a retrospective cohort study of youth (aged 5-20 years) who initiated AAP treatment. In AAP-treated youth, concomitant antidepressant (selective serotonin reuptake inhibitors [SSRI]/serotonin-norepinephrine reuptake inhibitors [SNRIs], tricyclic/other cyclic antidepressants [TCAs], and other antidepressants) or stimulant use was assessed. The risk of incident T2DM was estimated using discrete time failure models, adjusting for disease risk score estimated using >125 baseline and time-dependent covariates. RESULTS Among 73,224 AAP initiators, 43.0% had concomitant antidepressant use (76.4% were SSRI/SNRIs) and 43.8% had concomitant stimulant use. The study cohort had an average follow-up of 24.8 months (median = 22.0 months, interquartile range [IQR] = 10.0-38.0 months). In current AAP-treated youth, concomitant SSRI/SNRI (relative risk [RR] = 1.84, 95% CI = 1.30-2.59) or TCA use (RR = 2.75, 95% CI = 1.28-5.87) was associated with an increased risk of T2DM. By contrast, concomitant use of other antidepressants or stimulants with AAPs was not associated with an increased risk of T2DM. In concomitant users of AAPs and SSRI/SNRIs, the risk of T2DM increased with the duration of SSRI/SNRI use (RR = 2.35, 95% CI = 1.15-4.83 for ≥180 days vs. 1-180 days) as well as with the cumulative SSRI/SNRI dose (RR = 1.99, 95% CI = 1.08-3.67 for >2,700 mg vs. 1-2,700 mg fluoxetine dose equivalents), after adjusting for the duration and cumulative dose of AAP use. By contrast, in concomitant users of AAPs and stimulants, neither duration nor cumulative dose of stimulants was associated with an increased risk of T2DM. CONCLUSION In AAP-treated Medicaid-insured youth, concomitant SSRI/SNRI use was associated with a heightened risk of T2DM, which intensified with increasing duration and dose.
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Salvi V, Grua I, Cerveri G, Mencacci C, Barone-Adesi F. The risk of new-onset diabetes in antidepressant users - A systematic review and meta-analysis. PLoS One 2017; 12:e0182088. [PMID: 28759599 PMCID: PMC5536271 DOI: 10.1371/journal.pone.0182088] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 07/12/2017] [Indexed: 12/02/2022] Open
Abstract
Background Antidepressant Drugs (ADs) are among the most commonly prescribed medications in developed countries. The available epidemiological evidence suggests an association between AD use and higher risk of developing type 2 diabetes mellitus. However, some methodological issues make the interpretation of these results difficult. Moreover, very recent studies provided conflicting results. Given the high prevalence of both diabetes and AD use in many countries, clarifying whether this association is causal is of extreme relevance for the public health. The aim of the present study is to provide an up-to-date evaluation of the evidence in support of a causal role of ADs in inducing diabetes. Methods and findings A systematic literature search was conducted to identify relevant studies in MEDLINE (PubMed), PsycINFO, and International Pharmaceutical Abstracts (IPA) through 31st December 2016. Only studies assessing the incidence of new-onset diabetes in subjects treated with ADs were included. Results were pooled using a random-effects meta-analysis. Moreover, we extensively reviewed the role of the different sources of bias that have been proposed to explain the association between AD and diabetes. Twenty studies met the inclusion criteria. In the meta-analysis, the association between AD use and diabetes was still evident after the inclusion of the recent negative studies [pooled relative risk = 1.27, 95% confidence interval (CI), 1.19–1.35; p<0.001]. None of the biases proposed by previous authors seemed able to fully explain the observed association. Conclusions This updated meta-analysis confirms the association between AD use and incident diabetes. It still remains a matter of debate whether single ADs exert a different effect on the risk of diabetes. Given the possible heterogeneity, we suggest that a classification of ADs according to their pharmacological profiles could be useful in better elucidating the nature of this association.
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Affiliation(s)
- Virginio Salvi
- Department of Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
- * E-mail:
| | - Ilaria Grua
- Department of Pharmaceutical Sciences, University of Eastern Piedmont, Novara, Italy
| | - Giancarlo Cerveri
- Department of Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
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Carvalho AF, Sharma MS, Brunoni AR, Vieta E, Fava GA. The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature. PSYCHOTHERAPY AND PSYCHOSOMATICS 2017; 85:270-88. [PMID: 27508501 DOI: 10.1159/000447034] [Citation(s) in RCA: 348] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 05/24/2016] [Indexed: 11/19/2022]
Abstract
Newer generation antidepressant drugs (ADs) are widely used as the first line of treatment for major depressive disorders and are considered to be safer than tricyclic agents. In this critical review, we evaluated the literature on adverse events, tolerability and safety of selective serotonin reuptake inhibitors, serotonin noradrenaline reuptake inhibitors, bupropion, mirtazapine, trazodone, agomelatine, vilazodone, levomilnacipran and vortioxetine. Several side effects are transient and may disappear after a few weeks following treatment initiation, but potentially serious adverse events may persist or ensue later. They encompass gastrointestinal symptoms (nausea, diarrhea, gastric bleeding, dyspepsia), hepatotoxicity, weight gain and metabolic abnormalities, cardiovascular disturbances (heart rate, QT interval prolongation, hypertension, orthostatic hypotension), genitourinary symptoms (urinary retention, incontinence), sexual dysfunction, hyponatremia, osteoporosis and risk of fractures, bleeding, central nervous system disturbances (lowering of seizure threshold, extrapyramidal side effects, cognitive disturbances), sweating, sleep disturbances, affective disturbances (apathy, switches, paradoxical effects), ophthalmic manifestations (glaucoma, cataract) and hyperprolactinemia. At times, such adverse events may persist after drug discontinuation, yielding iatrogenic comorbidity. Other areas of concern involve suicidality, safety in overdose, discontinuation syndromes, risks during pregnancy and breast feeding, as well as risk of malignancies. Thus, the rational selection of ADs should consider the potential benefits and risks, likelihood of responsiveness to the treatment option and vulnerability to adverse events. The findings of this review should alert the physician to carefully review the appropriateness of AD prescription on an individual basis and to consider alternative treatments if available.
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Affiliation(s)
- André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
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Cognitive impairment in diabetes and poor glucose utilization in the intracellular neural milieu. Med Hypotheses 2017; 104:160-165. [DOI: 10.1016/j.mehy.2017.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 05/30/2017] [Accepted: 06/07/2017] [Indexed: 02/01/2023]
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Sundbøll J, Schmidt M, Adelborg K, Pedersen L, Bøtker HE, Videbech P, Sørensen HT. Impact of pre-admission depression on mortality following myocardial infarction. Br J Psychiatry 2017; 210:356-361. [PMID: 28254961 DOI: 10.1192/bjp.bp.116.194605] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/18/2016] [Accepted: 11/18/2016] [Indexed: 02/03/2023]
Abstract
BackgroundThe prognostic impact of previous depression on myocardial infarction survival remains poorly understood.AimsTo examine the association between depression and all-cause mortality following myocardial infarction.MethodUsing Danish medical registries, we conducted a nationwide population-based cohort study. We included all patients with first-time myocardial infarction (1995-2014) and identified previous depression as either a depression diagnosis or use of antidepressants. We used Cox regression to compute adjusted mortality rate ratios (aMRRs) with 95% confidence intervals.ResultsWe identified 170 771 patients with first-time myocardial infarction. Patients with myocardial infarction and a previous depression diagnosis had higher 19-year mortality risks (87% v. 78%). The overall aMRR was 1.11 (95% CI 1.07-1.15) increasing to 1.22 (95% CI 1.17-1.27) when including use of antidepressants in the depression definition.ConclusionsA history of depression was associated with a moderately increased all-cause mortality following myocardial infarction.
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Affiliation(s)
- Jens Sundbøll
- Jens Sundbøll, MD, Morten Schmidt, MD, PhD, Kasper Adelborg, MD, Department of Clinical Epidemiology and Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Lars Pedersen, PhD, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Hans Erik Bøtker, MD, PhD, DMSci, Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark; Poul Videbech, MD, DMSci, Psychiatric Centre Glostrup, Glostrup, Denmark; Henrik Toft Sørensen, MD, PhD, DMSci, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Morten Schmidt
- Jens Sundbøll, MD, Morten Schmidt, MD, PhD, Kasper Adelborg, MD, Department of Clinical Epidemiology and Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Lars Pedersen, PhD, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Hans Erik Bøtker, MD, PhD, DMSci, Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark; Poul Videbech, MD, DMSci, Psychiatric Centre Glostrup, Glostrup, Denmark; Henrik Toft Sørensen, MD, PhD, DMSci, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Kasper Adelborg
- Jens Sundbøll, MD, Morten Schmidt, MD, PhD, Kasper Adelborg, MD, Department of Clinical Epidemiology and Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Lars Pedersen, PhD, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Hans Erik Bøtker, MD, PhD, DMSci, Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark; Poul Videbech, MD, DMSci, Psychiatric Centre Glostrup, Glostrup, Denmark; Henrik Toft Sørensen, MD, PhD, DMSci, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Pedersen
- Jens Sundbøll, MD, Morten Schmidt, MD, PhD, Kasper Adelborg, MD, Department of Clinical Epidemiology and Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Lars Pedersen, PhD, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Hans Erik Bøtker, MD, PhD, DMSci, Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark; Poul Videbech, MD, DMSci, Psychiatric Centre Glostrup, Glostrup, Denmark; Henrik Toft Sørensen, MD, PhD, DMSci, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Erik Bøtker
- Jens Sundbøll, MD, Morten Schmidt, MD, PhD, Kasper Adelborg, MD, Department of Clinical Epidemiology and Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Lars Pedersen, PhD, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Hans Erik Bøtker, MD, PhD, DMSci, Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark; Poul Videbech, MD, DMSci, Psychiatric Centre Glostrup, Glostrup, Denmark; Henrik Toft Sørensen, MD, PhD, DMSci, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Poul Videbech
- Jens Sundbøll, MD, Morten Schmidt, MD, PhD, Kasper Adelborg, MD, Department of Clinical Epidemiology and Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Lars Pedersen, PhD, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Hans Erik Bøtker, MD, PhD, DMSci, Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark; Poul Videbech, MD, DMSci, Psychiatric Centre Glostrup, Glostrup, Denmark; Henrik Toft Sørensen, MD, PhD, DMSci, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Toft Sørensen
- Jens Sundbøll, MD, Morten Schmidt, MD, PhD, Kasper Adelborg, MD, Department of Clinical Epidemiology and Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Lars Pedersen, PhD, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Hans Erik Bøtker, MD, PhD, DMSci, Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark; Poul Videbech, MD, DMSci, Psychiatric Centre Glostrup, Glostrup, Denmark; Henrik Toft Sørensen, MD, PhD, DMSci, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
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Trikkalinou A, Papazafiropoulou AK, Melidonis A. Type 2 diabetes and quality of life. World J Diabetes 2017; 8:120-129. [PMID: 28465788 PMCID: PMC5394731 DOI: 10.4239/wjd.v8.i4.120] [Citation(s) in RCA: 286] [Impact Index Per Article: 40.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/24/2016] [Accepted: 01/18/2017] [Indexed: 02/05/2023] Open
Abstract
It is true that a primary goal of diabetes early diagnosis and treatment is quality of life (QoL). The term QoL is still confusing but it is agreed that it composes of four components: The physical component, mental, cogitative component, psychological and social component. Many articles have been written addressing those four components. During the last five years 15500 articles and reviews have been written addressing diabetes and coronary arterial disease, 16100 addressing diabetes and renal function, 28900 addressing diabetes and retinopathy, 16800 addressing diabetic foot ulcers and other 26300 addressing diabetic neuropathy. Moreover 17200 articles are dealing with diabetic sexual dysfunction, 24500 with the correlation of diabetes and depression 17500 about diabetes and dementia, only 1 about diabetes and family functioning and 1950000 about diabetes and QoL, indicating the worldwide interest. In order to confront this metabolic anomaly and its consequences, researchers developed numerous generic and disease specific psychometric tools. With the aid of those psychometric tools the scientific community has started to realize the gruesome effect of diabetes on patients’ lives. Diabetic’s QoL becomes worse when complications start to develop or comorbidities coexist. Dominant amongst complications, in health-related quality of life (HRQoL) lowering, but not related to risk factors (genetic, the weight of birth, or others) is coronary arterial disease followed by renal failure, blindness, and the combination of micro- and macro-vascular complications and in some studies by sexual dysfunction. Moreover many are the comorbidities which deteriorate further the effect of diabetes in a patient life. Among them obesity, hypertension, dyslipidemia, depression, arthritis are the most common. Most intriguing field for research is the interaction of diabetes and depression and in some cases the progression to dementia. Many aspects and combinations of actions are under researchers’ microscope regarding the improvement of HRQoL scores. Until now, the studies performed, have demonstrated little to moderate benefit. More of them are needed to draw safe conclusions on the topic of the best combination of actions to optimize the HRQoL scores.
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Perez A, Cabrera P, Gutierrez C, Valdes J. A Comparison of the Use of Antidepressant Treatment Between Non-Hispanic Black and White and Mexican American Adults With Type 2 Diabetes in the United States. DIABETES EDUCATOR 2017; 43:171-179. [DOI: 10.1177/0145721717697191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The purpose of this study was to determine antidepressant use among Mexican Americans (MA) and non-Hispanic (NH) blacks and whites with type 2 diabetes and depressive symptoms. Methods A secondary data analysis based on National Health and Nutrition Examination Survey (NHANES) 2005-2012 cohort data included 560 noninstitutionalized civilian MA, NH black, and NH white adults with type 2 diabetes and depressive symptoms. Unadjusted and adjusted 2-way ANOVA models evaluated whether there was a difference in the use of antidepressants by depressive symptom level across race/ethnic group. Results Whites were more likely than blacks and MA to be on antidepressant treatment (whites: 41.7%, blacks: 27.1%, MA: 24.2%) and on serotonin-norepinephrine reuptake inhibitors (SNRI) (whites: 8.1%, blacks: 2.9%, MA: 2.4%). However, there was no difference in the use of other drug classes or antidepressant use by depressive symptom level across racial/ethnic group. Followed by tricyclic antidepressants (TCA), selective serotonin reuptake inhibitors (SSRI) were the most commonly used drug class overall. Approximately 30% of subjects were on antidepressants and among those, 80% were on one antidepressant, all others on 2 or more. Conclusions Racial/ethnic differences were observed in the use of antidepressant treatment but not when depressive symptom levels were incorporated in the analyses. Further studies on the effectiveness of different antidepressants in diabetes outcomes minorities are needed.
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Affiliation(s)
- Alexandra Perez
- Sociobehavioral and Administrative Pharmacy Department, Nova Southeastern University College of Pharmacy, Davie, FL (Dr Perez)
- Nova Southeastern University College of Pharmacy, Davie, FL (Dr Cabrera, Dr Gutierrez)
- Pharmacy Practice Department, Nova Southeastern University College of Pharmacy, Palm Beach Gardens, FL (Dr Valdes)
| | - Pierina Cabrera
- Sociobehavioral and Administrative Pharmacy Department, Nova Southeastern University College of Pharmacy, Davie, FL (Dr Perez)
- Nova Southeastern University College of Pharmacy, Davie, FL (Dr Cabrera, Dr Gutierrez)
- Pharmacy Practice Department, Nova Southeastern University College of Pharmacy, Palm Beach Gardens, FL (Dr Valdes)
| | - Carolina Gutierrez
- Sociobehavioral and Administrative Pharmacy Department, Nova Southeastern University College of Pharmacy, Davie, FL (Dr Perez)
- Nova Southeastern University College of Pharmacy, Davie, FL (Dr Cabrera, Dr Gutierrez)
- Pharmacy Practice Department, Nova Southeastern University College of Pharmacy, Palm Beach Gardens, FL (Dr Valdes)
| | - Jose Valdes
- Sociobehavioral and Administrative Pharmacy Department, Nova Southeastern University College of Pharmacy, Davie, FL (Dr Perez)
- Nova Southeastern University College of Pharmacy, Davie, FL (Dr Cabrera, Dr Gutierrez)
- Pharmacy Practice Department, Nova Southeastern University College of Pharmacy, Palm Beach Gardens, FL (Dr Valdes)
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Mendenhall E, Kohrt BA, Norris SA, Ndetei D, Prabhakaran D. Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations. Lancet 2017; 389:951-963. [PMID: 28271846 PMCID: PMC5491333 DOI: 10.1016/s0140-6736(17)30402-6] [Citation(s) in RCA: 256] [Impact Index Per Article: 36.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/01/2016] [Accepted: 11/30/2016] [Indexed: 12/11/2022]
Abstract
The co-occurrence of health burdens in transitioning populations, particularly in specific socioeconomic and cultural contexts, calls for conceptual frameworks to improve understanding of risk factors, so as to better design and implement prevention and intervention programmes to address comorbidities. The concept of a syndemic, developed by medical anthropologists, provides such a framework for preventing and treating comorbidities. The term syndemic refers to synergistic health problems that affect the health of a population within the context of persistent social and economic inequalities. Until now, syndemic theory has been applied to comorbid health problems in poor immigrant communities in high-income countries with limited translation, and in low-income or middle-income countries. In this Series paper, we examine the application of syndemic theory to comorbidities and multimorbidities in low-income and middle-income countries. We employ diabetes as an exemplar and discuss its comorbidity with HIV in Kenya, tuberculosis in India, and depression in South Africa. Using a model of syndemics that addresses transactional pathophysiology, socioeconomic conditions, health system structures, and cultural context, we illustrate the different syndemics across these countries and the potential benefit of syndemic care to patients. We conclude with recommendations for research and systems of care to address syndemics in low-income and middle-income country settings.
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Affiliation(s)
- Emily Mendenhall
- School of Foreign Service, Georgetown University, Washington, DC, USA.
| | - Brandon A Kohrt
- Department of Psychiatry, Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Shane A Norris
- MRC Developmental Pathways for Health Research Unit, Faculty of Health, University of the Witwatersrand, Johannesburg, South Africa
| | - David Ndetei
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya; Africa Mental Health Foundation, Nairobi, Kenya
| | - Dorairaj Prabhakaran
- Public Health Foundation of India, Centre for Chronic Disease Control, New Delhi, India; London School of Hygiene & Tropical Medicine, London, UK
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Sweatman C, Lauerer JA, Pruitt C, Drayton SJ. Major Depressive Disorder or Diabetes-Related Distress? Screening, Evaluation, and Treatment in Adults With Diabetes. J Nurse Pract 2017. [DOI: 10.1016/j.nurpra.2016.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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